256443 03/15/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 201250
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECKAMOUNT: $*******145.00*
CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 256443
FISHERSIN 46038 CHECK DATE: 03/15/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 88742 145.00 OTHER EXPENSES
VOUCHER # 154435 WARRANT# ALLOWED
201250 IN SUM OF $
MID STATE TRUCK EQUIP CORP
11020 ALLISONVILLE RD
FISHERS, IN 46038
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
88742 01-6500-04 $145.00
Voucher Total $145.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
201250
MID STATE TRUCK EQUIP CORP Purchase Order No.
11020 ALLISONVILLE RD Terms
FISHERS, IN 46038 Due Date 2/29/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/29/2016 88742 $145.00
hereby certify that the attached invoice(s), or bill(s) is (are)true and
.Orrect and I have audited same in accordancewith IC 5-11-10-1.6
Date Officer
MID-STATE TRUCK EQUIPMENT e k � pR Jj Invoice
11020 Allisonville Road Invoice Number:
Retail#: 001104675-001-0 88742
Fishers, IN 460381
_.,.
P1itJ-Stacc,) ruck Equipment Invoice Date:
tnAan poais
Phone: 317.849.4903
Fax : 317.849.6441 www.mid-statetruck.com 2/25/2016
Bill To Ship To
CARMEL WATER DISTRIBUTION
3450 W. 131st St.
Westfield, IN 46074-8267
Handling charge added to Credit Customer P.O. No. Terms
Card orders over$500.00: 2.5%on
Visa, M/C,AMEX&Discover WILLIAM BELL NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
2/25/2016 3/21/2016
{ Qty Item Code Description Price Ea. Extension
1' HYD01603 CYLINDER,ANGLE V 10"xl-1/2"SA 145.00 145.00
WILLIAM BELL TRUCK 119
Serial #
Serial #
Subtotal $145.00
Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00
Credit Card [ ] Auth. # Total Invoice Amount $145.00
Payment Received $0.00
Received bJ f Date D-AX-14,
Balance Due $145.00
Thank you for your business!