325045 05/09/18 (9,
CITY OF CARMEL, INDIANA VENDOR: 201250ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: $*******778.20*
CARMEL, INDIANA 46032 11020'ALL1lSONVILLE RD CHECK NUMBER: 325045
FISHERS IN 46038 CHECK DATE: 05/09/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 99767 778.20 OTHER EXPENSES
VOUCHER NO. 185452 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor# 201250 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
MID STATE TRUCK EQUIP CORP CITY OF CARMEL
11020 ALLISONVILLE RD An invoice or bill to be properly itemized must show: kind of service,where performed,
FISHERS, IN 46038 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
778.20 201250 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR MID STATE TRUCK EQUIP CORP Terms
Carmel Wasterwater Utility 11020 ALLISONVILLE RD Due Date
BOARD MEMBERS
I hereby certify that that attached invoice FISHERS, IN 46038
(s),
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
99767 01-7502-06 $778,20 and received except 5/3/2018 99767 $778,20
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_
Clerk-Treasurer
Mid-State Truck Equipment Inc. Invoice
11020 Allisonville Rd Invoice Number:V
Fishers, IN 46038 99767
Invoice Date:
Phone: 317-849-4903
Fax : 317-849-6441
www.mid-statetruck.com 4/27/2018
Bill To Ship To
CARMEL UTILITIES Duane
9609 HAZEL DELL PKWY
INDIANAPOLIS, IN 46280
Handling charge added to Credit Customer P.O. No. Terms
Card orders over$500.00: 2.5% on
Visa, MIC,AMEX&Discover S18348 NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
X cust. pick-up 5/22/2018 -
Qty.tem Code DescriptionPrice Ea: Extension
2 P7ARTSgX�00 T RM 1TX12X16,T HANDLE 345.00, 690,.00
Q . 44.10 88:20.
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Serial #
Serial #
Subtotal $778.20
Cash [ ] Check [ ] # Sales Tax (7.0%) $0.00
Credit Card [ ] Auth. # Total Invoice Amount $778.20
Payment Received $0.00
Received by Date
Balance Due $778.20
Thank you for your business!