309034 03/07/17 9�; s, CITY OF CARMEL, INDIANA VENDOR: 201250
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: $"`***`161.26*
s?_ ,r° CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK NUMBER: 309034
9 FISHERS IN 46038 CHECK DATE: 03/07/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 93775 161.26 REPAIR PARTS
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MID-STATE TRUCK EQUIPMENT Invoice
11020 Allisonville Road Invoice Number:
Retail#: 001104675-001-0 93775
Fishers, IN 46038 Mid•Statc Truck Equipment
Invoice Date:
tndi%wipobl.
Phone: 317.849.4903
www.mid-statetruck.com 2/20/2017
Fax : 317.849.6441
Bill To Ship To
CARMEL STREET DEPARTMENT
3400 West 131 Street
WESTFIELD, IN 46074
Handiina charge added to Credit Customer P.O. No. ! Terms
Card orders over$500.00: 2.5%on
Visa, MIC,AMEX&Discover TRUCK58 NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
CAM 2/20/2017 3/17/2017
Qty Item Code Description Price Ea. Extension
2 HYD01637 VALVE, CARTRIDGE LIFT & ANGLE 57.95 115.90
2 HYD01638 VALVE,ELECTRIC COIL (12V) 22.68 45.36
Serial # i
Serial #
Subtotal $161.26
Cash [ ] Check [ ] # Sales Tax (7.0%) -�_ $11.29
Total Invoice Amount $172.55
Credit Card [ ] Auth. #
Payment Received $0.00
Received bDate
1 Balance Due $172.55
Thank you for your business!