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181153 01/13/2010 VOIDED CITY OF CARMEL, INDIANA VENDOR: 00351011 Page 1 of 1 r o 9 ONE CIVIC SQUARE CLARK TRUCK EQUIPMENT CO CHECK AMOUNT: $33.45 L� CARMEL, INDIANA 46032 PO BOX 27 c, o LINDEN IN 47955 CHECK NUMBER: 181153 CHECK DATE: 1/13/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 38223 33.45 REPAIR PARTS INVOICE NUMBER DATE OF ORDER CUSTOMER ORDER NO TERMS 12/09/09 MIKE NET 30 38223 DATE SHIPPED SHIP VIA PPD ADD COLL 12/14/09 SHIPPED DIRECT FROM EAGLELIFT SHIP TO TRUCK EQUIPMENT CO., INC. 105 W 580 N CRAWFORDSVILLE, IN 47933 PHONE 765 -362 -4101 sow CARMEL STREET DEPT. WATTS 1- 800 382 -0873 TO 3400 W. 131 ST FAX 765- 362 -4103 WESTFIELD, IN 46074 ACCOUNTS PAYABLE QUANTITY QUANTITY ORDERED BACKORDR DESCRIPTION PART NO. UNIT PRICE AMOUNT 421 b0'b3 TOP COVER -19 700 SUBTOTAL $19.00 TAX LABOR TERMS: NET 30 DAYS, 1 1/2% INTEREST PER MONTH FREIGHT /SHPG 14.45 ON UNPAID BALANCE AFTER 30 DAYS TOTAL INVOICE $33.45 VOUCHER NO. WARRANT NO. ALLOWED 20 Clark Truck Equipment IN SUM OF 105 W. 580 N. Crawfordsville, IN 47933 $33.45 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 38223 42- 370.00 $33.45 I hereby certify that the attached invoice(s), or 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 Thu fsd'ay, January 07, 2010 L Zu r Street Commissioner Stroot ,Title ier Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12/09/09 38223 $33.45 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 Clerk- Treasurer