165339 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: 201250 Page 1 of 1
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP
CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK AMOUNT: $35.92
FISHERS IN 46038
CHECK NUMBER: 165339
CHECK DATE: 10129/2008
DEPARTM ACCOUNT PO NUM IN VOICE NU MBER AMOUNT DESCRIPTION
651 5023990 50416 35.92 OTHER 'EXPENSES
I
i
i
MID -STATE TRUCK EQUIPMENT INC Invoice
11020 Allisonville Road Invoice Number:
Retai I 001104675 -001 -0 50416
Fishers, IN 46038
Invoice Date:
Phone: 317.849.4903 www. mid-statetruck.com
10/8/2008
Fax 317.849.6441
Bill To Ship To
CARMEL UTILITIES CARMEL WASTEWATER
3450 W 131 ST. ST
Westfield, IN 46074 -8267
Handling charge added to Credit Customer P.O. No. Terms
Card orders over $500.00: Visa
WC 2 AMEX Discover 3% JEFF NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
DM 10/8/2008 11/2/2008
Qty Item Code Description Price Ea. Extension
2 PARTS 1 0810 650911 EYE -BOLT 1.00 2.00
2 PARTS 0715- 619601 SPRING 5.33 10.66
2 PARTS 1 0311 862272 RUBBER BUMPER 11.63 23.26
7� 06
Serial
REM 00T 0 8 2 90total $35.92
Serial
Sales Tax (7.0 $0.00
Total Invoice Amount $35.92
Received by
Payment Received $0.00
Check# Authorization Code Balance Due $35.92
Thank you for your business!
VOUCHER 086491 WARRANT ALLOWED
20`250 IN SUM OF
MID STATE TRUCK EQUIP CORP
11020 ALLISONVILLE RD
FISHERS, IN 46038
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
50416 01- 7502 -06 $35.92
a�
Voucher Total $35.92
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
201250
MID STATE TRUCK EQUIP CORP Purchase Order No.
11020 ALLISONVILLE RD Terms
FISHERS, IN 46038 Due Date 10/21/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/21/2W 50416 $35.92
r
hereby certify that the attached invoice(s), or bill(s) is (are) true and
,orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer