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331742 10/30/18 4{o:C�gMf CITY OF CARMEL, INDIANA VENDOR: 008050 ® ONE CIVIC SQUARE ACTION EQUIPMENT INC CHECK AMOUNT: $********55.50* �� =a, CARMEL, INDIANA 46032 5801 S.HARDING ST CHECK NUMBER: 331742 .y��TON�° INDIANAPOLIS IN 46217 CHECK DATE: 10/30/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 PS118-09958 55.50 OTHER EXPENSES VOUCHER NO. 186751 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995) Vendor # 8050 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER ACTION EQUIPMENT INC CITY OF CARMEL 5801 S. HARDING ST An invoice or bill to be properly itemized must show: kind of service,where performed, INDIANAPOLIS, IN 46217 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit,etc. Payee 55.50 8050 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR ACTION EQUIPMENT INC Terms Carmel Wasterwater Utility 5801 S. HARDING ST Due Date BOARD MEMBERS I hereby certify that that attached invoice INDIANAPOLIS,IN 46217 (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 PSI18-09958 01-7202-05 $55.50 and received except 10/25/2018 PSI18-09958 _T $55.50 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 INVOICE Invoice Number: PS118-09958 Invoice Date Due Date Ship Date Page:1 10/19/2018 10/29/2018 10/19/2018 Customer ID Contact SalesPerson Action Equipment Sales Co., Inc. CARM01 KERRI-A/P LAURIE 5801 S. Harding Street Cust.Phone Cust.Fax Sales Order No. Indianapolis, IN 46217 317-571-2443 317-571-2265 S018-06424 djarvis@carmel.in.gov Bill CARMEL UTILITIES Ship CARMEL WASTE WATER To: KERRI -A/P To: RICK MATLOCK WASTEWATER 9609 HAZEL DELL PARKWAY 9609 HAZEL DELL PARKWAY CARMEL, IN 46280 INDIANAPOLIS, IN 46280 Terms Ext Doc No. Your Reference Ship Via Loc Code Loc Phone Loc Fax Net 10 days WILL CALL INDPLS Number Description Order Qty Unit n i Unit Price Total Price 87077900 NOZZLE WTR Fix 1/41VI 6 EA 6 9.25 55.50 Received by : ®ate: o-aw ►g PO #: cct #: Use A -zzles Coo Clog Website: actionequipmentsales.com Phone: 317-788-9781 Fax: 317-788-9726 Amount Subject to Amount Exempt Subtotal: 55.50 Sales Tax from Sales Tax Invoice Discount: 0.00 0.00 55.50 Total Sales Tax: 0.00 Total: 55.50 ACTION EQUIPMENT SALES CO., INC. INDIANAPOLIS EVANSVILLE LOUISVILLE (317) 788-9781 (812)423-7974 (502)964-4464 CHEMICAL EMERGENCY # 800-535-5053 - 1 jkll DATE: SOLD TO I • ADDRESS 2 CITY STATE ZIP • PHONE( ) COUNTY • ATTN: CUSTOMER ORDER NO. DATE SHIPPED SHIPPED VIA SIC k TERMS SALES REP. TAX N/C PPA,---CQLL. UPS DELIVER W/C FRT. QTY ORD'D QTY BO DESCRIPTION QTY SHP'DUNIT PRICE AMOUNT © r71 :a PURCHASERS SIGNATURE 3 -