175023 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 201250 Page 1 of 1
1 ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP
CARMEL, INDIANA 46032 11020 ALLISONVILLE RD CHECK AMOUNT: $88.00
o FISHERS IN 46038 CHECK NUMBER: 175023
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOIC N UMBER AMOUNT DESCRIPTION
2201 4237000 53944 88.00 REPAIR PARTS
i.
MID -STATE TRUCK EQUIPMENT INC. ;IIlV01CG
11020 Allisonville Road Invoice Number:
Retail 001104675 -001 -0 53944
Fishers, IN 46038
Invoice Date:
Phone: 317.849.4903 www.mid- statetruck.com
6/29/2009
Fax 317.849.6441
Bill To Ship To
CARMEL STREET DEPARTMENT
3400 West 131 Street
Westfield, IN 46074
Handling charge added to Credit Customer P.O. No. Terms
Card orders over $500:90: Visa
M/C 2 AMEX Discover 3% tuck 109 NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
TMB P 6/29/2009 7/24/2009
Qty Item Code Description Price Ea. Extension
1 PARTS 1 320131 4 -way electronic solenoid valve 78.00 78.00
1 freight freight /shipping/handling 10.00' 10.00
j
I
i
Serial
Serial Subtotal $88.00
Sales Tax (7.0 $0.00
Received by
Total Invoice Amount $88.00
Payment Received $0.00
Check# Authorization Code: Balance Due $88.00
Th ank yo u for yo ur b usiness!
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))
06/29/09 53944 $88.00
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
20
Clerk- Treasurer
VOUCHER NO. WARRAN NO.
ALLOWED 20
Mid -State Truck Equipment
IN SUM OF
11020 Allisonville Road
Fishers, IN 46038
$88.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member:
2201 53944 42- 370.00 $88.00 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
i Friday July 17, 200
Street Comm S!�Ipner
Cost distribution ledger classification if
claim paid motor vehicle highway fund