178285 10/14/2009 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: $685.00
FISHERS IN 46038
CHECK NUMBER: 178285
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM OUNT DESCRIPTION
1205 4350000 54519 685.00 EQUIPMENT REPAIRS M
5'
TO
MID -STATE TRUCK EQUIPMENT Invoke
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11020 Allisonville Road r Invoice Number:
Retail 001104675 -001 -0 s 54519
Fishers, IN 46038 kii-SC;,re,rr f oiomeo
Invoice Date:
iidesis.t�sa3i3
Phone: 317.849.4903
Fax 317.849.6441
www.mid 10/2/2009
Bill To Ship To
CARMEL CITY HALL
1 CIVIC SQUARE
CARMEL, IN 46032
Handling charge added to Credit Customer P.O. No. Terms
Cant Ordars- nver_$.5o�_OO' _:.Visa
MIC 2 AMEX Discover 3% JEFF BARNES NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
10/2/2009 10/27/2009
Qty Item Code Description Price Ea. Extension
1 'PARTS 1 WP63392 WIRING HARNESS 295.00 295.00
1 'solenoid solenoid for snow plow (repl.) 25.00' 25.00
1 labor hourly labor /installation fee WESTERN WIRING 350.00' 350.00
HARNESS,SOLENOID
1 ;shop -001 miscellaneous shop supplies 15.00' 15.00
WORK ORDER 461245 CHEV. VIN: IZ295283
Serial
Serial Subtotal $685.00
Sales Tax (7.0 $0.00
Total Invoice Amount $685.00
Received by Payment Received $0.00
Check# /Authorization Code Balance Du e $685.00
fan y ®u f ®r your business!
Pres6lbed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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 l
M A Purchase Order No.
Terms
isL�e� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1 z J Sg'5m �S5. �o
TotalL
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
`'OUCHER NO. z WARRANT NO.
ALLOWED 20
"A IN SUM OF
bps
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
I Z�5 SaS i s �S 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
20
a
g
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund