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184712 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 00351011 Page 1 of 1 ONE CIVIC SQUARE CLARK TRUCK EQUIPMENT i 0 CHECK AMOUNT: $111.00 �+a CARMEL, INDIANA 46032 105 W 580 N CRAWFORDSVILLE IN 47933 CHECK NUMBER: 184712 CHECK DATE: 4/27/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 38825 111.00 REPAIR PARTS INVOICE NUMBER DATE OF ORDER CUSTOMER ORDER NO. TERMS 04/09/10 NET 30 38825 DATE SHIPPED SHIP VIA PPD ADD COLL 4/21/10 CTE TO DELIVER SHIP I C(7. �LN-\\ TO TRUCK EQUIPMENT CO., INC. J 105 W 580 N CRAWFORDSVILLE, IN 47933 PHONE 765- 362 -4101 SOLD CARMEL STREET DEPT WATTS 1- 800 -382 -0873 TO 3400 W 131 ST FAX 765 362 -4103 WESTFIELD, IN 46074 QUANTITY QUANTITY OR DERED BACKORDR DESCRIPTION PART NO. UNIT PRICE AMOUNT 1 84765 1 84768 REAR CORNER POST ASSY. 95.00 1 80411 D/S SUBTOTAL $95.00 FREIGHT /SHPG 16.00 LABOR TERMS: NET 30 DAYS, 1 112% INTEREST PER MONTH TAX #ON FILE ON UNPAID BALANCE AFTER 30 DAYS TOTAL INVOICE $111.00 V NO. WARRANT NO. ALLOWED 20 Clark Truck Equipment IN SUM OF 105 W. 580 N. Crawfordsville, IN 47933 $111.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# l Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 38825 42- 370.00 $111.00 1 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 ;Friday, Ail 23, 2010 Street CommissioW Street rnmmiecir)nPr Title 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)) 04/21/10 38825 $111.00 1 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