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195816 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 009987 Page 1 of 1 ONE CIVIC SQUARE ALTEC INDUSTRIES, INC CHECK AMOUNT: $643.18 CARMEL, INDIANA 46032 DRAWER 0414 Po Box 11407 CHECK NUMBER: 195816 °M BIRMINGHAM AL 35246 -0414 CHECK DATE: 3/29/2011 DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION 2201 4351000 5818651 643.18 AUTO REPAIR MAINTEN Page: 1 of 2 m� �a SERV.ICE:INUOICE. Please Remit To: Invoice Number Invoice Date Altec Industries, Inc. Altec Industries, Inc. 5818651 23 -MAR -11 5201 West 84th Street PO Box 11407 Indianapolis IN 46268 BIRMINGHAM AL 35246-0414 Request Na. Request Date United States United States 1655081 08- MAR -11 Terms Sale Order No. (87 7) 46 2-583 2 NET 30 1901635 S CARMEL STREET S CARMEL STREET O 3400 W 131 ST ST H ALTEC INDIANA SVC CTR L WESTFIELD IN 46074 1 5201 W 84TH ST D United States P INDIANAPOLIS IN 46268 T T United States p O Customer No. 11491 Site No. 230470 Site No. 250876 Customer Order No. Assembly No. Customer Vehicle No. Contact Name Contact Phone No. 027 2163219 300 JEFF STEWART 317 417 5053 In Service Date Device Serial No. Model Technician Odometer 26- FEB -04 01D4CV2665 LRV58 Jones, Eric LEE 35216 VIN Garage Lic. Plate No. Driver Eng. Meter Reading 1 HTMMAAN95H678103 IN 65633 1690 PTO Hours Credit /Fleet Card Information Crew No. VMS Note UP Note 658 Quantity UOM Part Number Description Price Extended Price Charge 1 EA 035330007- HYD. SPIN ON FILTER ELEMENT;RETURN $14.96 14.96 14.96 3 EA 040050001- GREASE ZERK;STRAIGHT;.19 IN OD;;;;; $0.54 1.62 1.62 1 EA 067040172- PLACARD; ENGLISH;SAFETY, DANGER :OUAL $5.00 5.00 5.00 1 EA 067040174- PLACARD; ENGLISH;SAFETY;OPERATING IN $1.50 1.50 1.50 1 EA 067040175- PLACARD ;ENGLISH;INFORMATION;NOTICE; $1.75 1.75 1.75 1 EA 067040177- PLACARD; ENGLISH ;SAFETY, DANGER;ELEC $2.25 2.25 2.25 1 EA 067040207- PLACARD;ENGLISH;SAFETY, DANGER;FALL $3.96 3.96 3.96 1 EA 705500139- GREASEJUBE $4.14 4,14 4.14 1 EA 970256469 PM INSPECTION; IYEAR INTERVAL;LARGE $450.00 450.00 450.00 1 EA 970256998- DIELECTRIC TEST; CAT B /C; BOOM LI $150.00 150.00 150.00 970032952- CHARGE;SVC;EDF /SHOP SUPPLIES 8.00 8.00 Sub Total $643.18 State Tax 7.0000% County Tax 0.0000% City Tax 0.0000% Total Tax $0.00 Total Invoice $643.18 VOUCHER NO. WARRANT NO. ALLOWED 20 Altec Industries, Inc. IN SUM OF P. O. Box 11407 Birmingham, A!_ 35246 -0414 $643.18 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Member 2201 5818651 43 510.00 $643.18 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 T�Yrsd arch 24, 2011 Strete ?�om0tT1s snner 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)) 03/23/11 5818651 $643.18 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 2Q Clerk- Treasurer