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179979 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 008050 Page 1 of 1 t ONE CIVIC SQUARE ACTION EQUIPMENT INC CARMEL, INDIANA 46032 5801 S. HARDING S7 CHECK AMOUNT: $656.25 INDIANAPOLIS IN 46217 CHECK NUMBER: 179979 CHECK DATE: 12/812009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4232100 PSI09 -9929 656.25 GARAGE MOTOR SUPPIE Remit to: S. Harding Street Inds Invoice Indianapolis, IN 46217 (317) 788 -9781 INDIANAPOLIS EOUIPMENT SALES CO., INC. (812) 423 -7974 EVANSVILLE (502) 964 -4464 LOUISVILLE INVOICE NUMBER: PS109 -9929 INVOICE DATE. 11/30/09 PAGE: 1 SOL CARMEL STREET DEPARTMENT SHIP CARMEL STREET DEPT- WESTFIEL TO: 3450 W 131 ST STREET TO: 3400 W. 131 ST STREET WESTFIELD, IN 46074 CARMEL, IN 46074 CUSTOMER I.D.: CARM01 SHIP VIA: DELIVER OUR TRUCK P.O. NUMBER: ACCT 321 SHIP DATE: P0. DATE: 11/23/09 DUE DATE: 12/10/09 OUR ORDER NO.: S009 -9702 TERMS: Net 10 days SALESPERSON: CO2 ITEM /DESCRIPTION UNIT ORDER QTY ©UANTITY UNIT PRICE TOTAL PRICE 54207 -1P BREAKTHROUGH PLUS GALLONS 125 125 5.25 656.25 AMOUNT SUBJECT AMOUNT EXEMPT SUBTOTAL:'F TO SALES TAX FROM SALES TAX U hl I "INVOICE DISCOUNT a 656.25 tSALE5,TAX 0 0.00 656.25 E 0.00 I INVOICE TOTAL 656.25 PAST DUE ACCOUNTS SUBJECT TO 1.5% SERVICE CHARGE PER MONTH le 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)) 11/30/09 PS109- 9929 $656.25 I 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 VOUCHER NO. WARRAN NO. Action Equipment ALLOWED 20 IN SUM OF 5801 S. Harding Street Indianapolis, IN 46217 $656.25 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Member 2201 PS109 -9929 42- 321.00 $656.25 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except �Frid 5 ce 2 V 8$ree19freetr0os'5miw i oner Title Cost distribution ledger classification if claim paid motor vehicle highway fund