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305227 11/14/16 �QQq.. 4 CITY OF CARMEL, INDIANA VENDOR: 201250 ® ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: $*****5,030.63* s ?a; CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 305227 9�i�oN..�o. FISHERS IN 46038 CHECK DATE: 11/14/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 91663 80.63 REPAIR PARTS 2201 4467099 91723 4,950.00 OTHER EQUIPMENT VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) MID STATE TRUCK EQUIP CORP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 11020 ALLISONVILLE RD 1N SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service FISHERS, IN 46038 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $80.63 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Street Department Terms Date Due PO# ACCT# DATE, INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 91663 42-370.00 $80.63 1 hereby certify that the attached invoice(s),or 10/31/16 91663 $80.63 2201 201 2201 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, November 08,2016 Dave Huffman Director I 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer MID-STATE TRUCK EQUIPMENT Invoice 11020 Allisonville Road X Retail#: 001104675-001-0 Invoice Number: s z 91663 Fishers, IN 46038 ` r , ?didStacC 7r'uck Egirnpmcnc' Invoice Date: Indanapats Phone: 317.849.4903 Fax : 317.849.6441 www mid-statetruck.com 10/31/2016 Bill To Ship To CARMEL STREET DEPARTMENT 3400 West 131 Street WESTFIELD, IN 46074 .- - -- ---- _ ---- :ter---- - - - - - —— - - - - - �- --- -- Handlin_g charge added to Credit Customer P.O. No. Terms Card orders over$500.00: 2.5%on Visa, MIC,AMEX&Discover 56 NET 25 Days Sales Rep ID Shipping Method Ship Date Due Date CAM 10/31/2016 11/25/2016 Qty Item Code Description Price Ea. Extension 1 HYD01637 VALVE, CARTRIDGE LIFT & ANGLE 57.95 57.95 1 HYD01638 VALVE,ELECTRIC COIL (12V)- 22.68 22.68 Serial # Serial # Subtotal $80.63 Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00 Credit Card r[ uth # Total Invoice Amount $80.63 Payment Received $0.00 Received by Date _$80. Balance Due $80.63 } Thank you for your business! VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) MID STATE TRUCK EQUIP CORP ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 11020 ALLISONVILLE RD IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service FISHERS, IN 46038 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $4,950.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoices)or bill(s)) AMOUNT 91723 44-670.99 $4,950.00 1 hereby certify that the attached invoice(s),or 11/2/16 91723 $4,950.00 2201 201 2201 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, November 08,2016 Dave Huffman Director I 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer MID-STATE TRUCK EQUIPMENT q a1F 9 +V,NttH '9 F 9t V 4?f Invoice +St11020 Allisonville Road Invoice Number: Retail#: 001104675-001-0 Fishers, IN 46038 91723 Mtd-Scace.Truck Eq npotcnc Invoice Date: tnd;tuapotr Phone: 317.849.4903 Fax : 317.849.6441 www.mid-statetruck.com 11/2/2016 Bill To Ship To CARMEL STREET DEPARTMENT Dave Huffman 3400 West 131 Street 2016 F-350 WESTFIELD,IN 46074 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 10/18/2016 11/27/2016 Qty Item Code Description Price Ea. Extension 1 BOSS80SU... BOSS RT3 810" SUPER-DUTY SNOWPLOW WITH 4,875.00 4,875.00 SMARTHITCH2 1 .STB03167 BLADE CRATE,81STR BLD SUPER 0.00 0.00 1 STB 15020B BOSS Plow box STR RT3 SH2,W/LED 0.00: 0.00 1 STB15103 a BOSS STRAIGHT BLADE CONTROL KIT- 0.000.00 SmartTouch2 1 LTA09060B BOSS FORD SD '11+RT3 U/C 0.00 0.00 1 MSC04599 LIGHT ADAPTER,OLD CHEVY/DODGE/FORD 13 0.00, 0.00 PIN 1 MSC01565 BOSS RUBBER SNOW DEFLECTOR 0.00: 0.00 1 PLOWINST... SNOWPLOW INSTALLATION CHARGE 450.00 450.00 DISCOUNT MUNICIPAL CUSTOMER DISCOUNT -375.00 -375.00 PLOW S/N 276968 BLADE S/N BC187618 Serial # Serial # Subtotal $4,950.00 Cash [ ] Check [ l # Sales Tax (7.0%) $0.00 Credit Card [] Auth. # Total Invoice Amount $4,950.00 Payment Received $0.00 Received by Date FBalance Due $4,950.00 Thank you for your business!