162872 08/20/2008 °Mf 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: $12.00
FISHERS IN 46038 CHECK NUMBER: 162872
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 50004 12.00 OTHER EXPENSES
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MID-STATE TRUCK EQUIPMENT INC. Invoice
11020 Allisonville Road Invoice Number:
Retail 001104675 -001 -0 50004
Fishers, IN 46038 Invoice Date:
Phone: 317.849.4903 www mid- statetruck.com 8/4/2008
Fax 317.849.6441
Bill To Ship To
CARMEL UTILITIES
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 BRAD OLIVER NET 25 Days
M/C 2%. AMEX Discover 390
Sales Rep ID Shipping Method Ship Date Due Date
TMB P 8/4/2008 8/29/2008
Qty Item Code Description Price Ea. E xtension
1 OTC PARTS GATE EYE BOLT W/ NUT 12.00 12•
RECD AUG 0 4 2008
J
Gl 75
Serial
Subtotal $12.00
Serial $0.00
Sales Tax (7.0
Total Invoice Amount $12.00
Received b Payment Received $0.00
Check# Authorization Code:
B�I�nCe �Du $12.00
'hank y ®u for your business!
VOUCHER 086067 WARRANT ALLOWED
201250 IN SUM OF
MrD 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
50004 01- 7502 -06 $12.00
Voucher Total $12.00
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 8/6/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/6/2008 50004 $12.00
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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
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