186940 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 201250 Page 1 of 1
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP
�a CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK AMOUNT: $160.89
FISHERS IN 46038
CHECK NUMBER: 186940
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 58363 160.89 REPAIR PARTS
t
MID -STATE TRUCK EQUIPMENT Invoice
11020 Allisonville Road Invoice Number:
Retail 001104675 -001 -0 58363
Fishers, IN 46038
=Scat iptvierrc
Invoice Date:
Phone: 317.849.4903
Fax 317.849.6441 www.ntid- statetruck.com 6/2 /2010
Bill To Ship To
CARMEL STREET DEPARTMENT
3400 West 131 Street
Westfield, IN 46074
Handling charge added to Credit Customer P.O. No. Terms
rare/ orders- over$500.00c- Wsa
M/C 2%, AMEX Discover 3% MK3900 NET 25 Days
Sales Rep ID Shipping.Method Ship Date Due Date
TMB P 6/2/2010 6/27/2010
Qty Item Code Description Price Ea. Exten sion
11 PARTS 1 .200043 ELECTRIC FAN 140.89 140.89
1 freight freight /shipping /handling 20.00 20.00
3
3
f
1
Serial
Serial Subtotal $160.89
Sales Tax (7.0 $0.00
Total Invoice Amount $160.89
Received by
Payment Received $0.00
Check# Authorization Code: L Bal Due 5160.89
Thacnk youfor your business!
VOU N WARRANT NO.
Mid -State Truck Equipment ALLOWED 20
IN SUM OF
11020 Allisonville Road
Fishers, IN 46038
$160.89
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO Dept. INVOICE NO. ACCT #!TITLE AMOUNT
Board Members
2201 58363 42- 370.00 $160.89 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
n F i
it Thursday J une 17, 2010
Street Commissioner
stl
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))
06/02/10 58363 $160.89
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