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250771 10/21/15 >.: .r. CITY OF CARMEL, INDIANA VENDOR: 201250 ,_ b 'i ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: $""""'1,675.00" CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 250771 �;y,TON�,? FISHERS IN 46038 CHECK DATE: 10/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4351000 85881 665.00 AUTO REPAIR & MAINTEN 2200 4350900 85899 505.00 OTHER CONT SERVICES 2200 4350900 85928 75.58 OTHER CONT SERVICES 2200 4351000 85928 429.42 AUTO REPAIR & MAINTEN Invoice MID-STATE TRUCK EQUIPMENT , ,, r.. ,tt;. .,,, ,'; , ,.., 11020 Allisonville Road { ' ' ' ` -;' " - Invoice Number: Retail#: 001104675-001-0 85881 Fishers, IN 46038 ,•= - m4-SEM0)'fru<k Equipment Invoice Date: �Ind� an. oir. Phone: 317.849.4903 � ^ Fax : 317.849.6441 www.mid-statetruck.com 10/6/2015 Bill To Ship To CITY OF CARMEL Kate Lustig ONE CIVIC SQUARE Engineering CARMEL, IN 46032 2015 Ford Escape VIN#1 FMCU9GXXGUA55305 Handling charge added to Credit Customer P.O. No. Terms Card orders over$500.00: 2.5%on Visa, M/C,AMEX&Discover NET 25 Days Sales Rep ID Shipping Method Ship Date Due Date JK cust. pick-up 10/5/2015 10/31/2015 `Qty Item Code Description Price Ea. Extension 5 ';LABOR 'Install customer provided Whelen Liberty light bar 80.00 400.00 3 !LABOR Install customer provided Whelen Vertex lights in 80.00' 240.00 headlights and reverse light lenses --Reverse light installation is not always possible 1 ,shop-001 'MISCELLANEOUS SHOP SUPPLIES 25.00! 25.00 --Additional wiring switches and terminals •x.280 - `-135 ► ooh i i Serial # Serial # Subtotal $665.00 Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00 Credit Card [ ] Auth. # Total Invoice Amount $665.00 Payment Received $0.00 Received by Date Balance Due $665.00 7'hacnk youfor your business! MID-STATE TRUCK EQUIPMENT ,._t s� {�, .>�.� Invoice 11020 Allisonville Road :�,., ' " '$°"� +� Invoice Number: Retail#: 001104675-001-0 85928 Fishers, IN 46038 ,.` . = Mui•S(atNTruci 6Qutpnient Invoice Date: �ti�dau .poh: Phone: 317.849.4903 Fax 317.849.6441 www.mid-statetruck.com 10/7/2015 : Bill To Ship To CITY OF CARMEL Kate Lustig ONE CIVIC SQUARE Engineering CARMEL, IN 46032 2015 Ford Escape VIN#1 FMC09GXGGUA55303 Handling charge added to Credit Customer P.O. No. Terms Card orders over$500.00: 2.5% on Visa, MIC, AMEX& Discover NET 25 Days Sales Rep ID Shipping Method Ship Date Due Date JK Gust. pick-up 10/7/2015 11/1/2015 Qty Item Code Description Price Ea. Extension - --- - p Liberty - - - --- - -- 3 ,LABOR 'Install customer provided Whelen Libe light bar80.00 240.00 3 LABOR Install customer provided Whelen Vertex lights in 80.00' 240.00 headlights and reverse light lenses --Reverse light installation is not always possible 1 'shop-00 I ;MISCELLANEOUS SHOP SUPPLIES 25.0025.00 --Additional wiring switches and terminals 429. 1F Z 2 2- 0 0 -- y 3 s 10 0 0 � � S..ss 22oc7 •- ti 3sogop i s j I ! 1 i Serial # Serial # Subtotal $505.00 Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00 Credit Card [ ] Auth. Total Invoice Amount $505.00 Payment Received $0.00 Received by Date/U Balance Due $505.00 _'hank y®u for your business! MID-STATE TRUCK EQUIPMENT71 Invoice 11020 Allisonville Road F " M �� -$ ��'' Invoice Number: Retail#: 001104675-001-0 A Ja. r g � �� Fishers, IN 46038 ,., f 85899 M1C!�Tru<k F.quipmenc Invoice Date: Indon,po4: Phone: 317.849.4903 ? ' Fax : 317.849.6441 www.mid-statetruck.com 10/6/2015 Bill To Ship To CITY OF CARMEL Kate Lustig ONE CIVIC SQUARE Engineering CARMEL, IN 46032 2015 Ford Escape VIN#1 FMCU9GX8GUA55304 Handling charge added to Credit Customer P.O. No. Terms Card orders over$500.00: 2.5% on Visa, MIC, AMEX&Discover NET 25 Days Sales Rep ID Shipping Method Ship Date Due Date X cust. pick-up 10/5/2015 10/31/2015 Qty Item Code Description Price Ea. Extension 3 :LABOR 'Install customer provided Whelen Liberty light bar 80.00 240.00 3 LABOR Install customer provided Whelen Vertex lights in 80.00 240.00 headlights and reverse light lenses --Reverse light installation is not always possible 1 shop-001 MISCELLANEOUS SHOP SUPPLIES 25.00' 25.00 --Additional wiring switches and terminals 2200 — H3s©9 cc; j i i i --- --- -- ------ ------ Serial # Serial # Subtotal $505.00 Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00 Credit Card [ ] Auth. # Total Invoice Amount $505.00 Payment Received $0.00 Received by Date Ballance Due $505.00 I nacnk you for your business! Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Mid-State Truck Equipment Purchase Order No. 11020 Allisonville Road Terms Fishers, IN 46038 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 10/6/2015 85881 Install Light Bar City Vehicle 1 $ 665.00 10/7/2015 85928 Install Light Bar City Vehicle 2 $ 429.42 10/7/2015 85928 Install Light Bar City Vehicle 2 $ 75.58 10/6/2015 85899 Install Light Bar City Vehicle 3 $ 505.00 Total $ 1,675.00 1 hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance with IC 5-11-10-1.6. ,20 Clerk-Treasurer VOUCHER NO WARRANT NO. Mid-State Truck Equipment ALLOWED 20 11020 Allisonville Road IN SUM OF $ Fishers, IN 46038 $ 1,675.00 ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 0 85881 2200-4351000 $ 665.00 bill(s) is (are)true and correct and that the materials or services itemized thereon for 0 85928 2200-4351000 $ 429.42 which charge is made were ordered and 0 85928 2200435090 s 75.58 received except 0 85899 2200-435090C s 505.00 10/19/2015 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund