180887 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 202000 Page 1 of 1
ONE CIVIC SQUARE MIDWEST BRAKE WHEEL, INC
CARMEL, INDIANA 46032 PO BOX 2933 CHECK AMOUNT: $302.40
INDIANAPOLIS IN 46206 -2933
CHECK NUMBER: 180887
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 1293500071 302.40 REPAIR PARTS
UV11OWES l BRAKE O W EEI VC. INVOICE DATE
12/16/20019
QD INVOICE NO. PAGE
1 t 1140 S. West Street P.O.Box 2933 3120 Congressional Pkwy. t INDIANAPOLIS IN 46206 -2933 FT. WAYNE, IN 46808 1293500071 1
Phone: (317) 632 -4487 Phone: (260) 482 -5243 CUSTOMER NO. BRANCH
www.mwbrake.com (800) 944 -9433 100.99
1
SOLD CITY OF C A,RMEL. SHIP CIT OF C, ARMEL
TO STREET DEPT TO STREET DEPT
3400 W '131ST STREET 3400 W '1 STREET
CARMEL, IN 46074 WESTFIELD IN 46074
PLEASE .REMIT TO: P.O. BOX 2933 INDIANAPOLIS, IN 46206 -2933
CUSTOMER PO. R/S ORDER NO.
899891 (317) 733-200 KC 004/00 001
QUANTITY I PART NO PRICE/PER EXTENSION
1 IRT 2115TI 3/8" TITANIUM IMPACT 46 /-1..49 265.00EA* 265.00
1 IRP 2 --TK2 TUNE UP KIT 79.36 37.40EA* 37.40
WILL CALL WILL CALL
ORDER PICKED BY: KC
ABEX, A l_COA,BAL.DWIIN,GUNITE,WEBB, TIMKEN
WE SUPPORT AMERICA BY SELLI AMERICAN MAiDl-. GOOD, 5!
r
CORES MUST BE RETURNED WITHIN 90 DAYS.
FREIGHT TAXABLE SUB TOTAL TAX STATUS /STATE SALES TAX. PLEASE PAY
302.40 E IN 0 00 302.40
PAYMENT TERMS: Open accounts due and payable on or before the 10th day of the month following the
date of purchase. Any account beyoll these term wil} be T ftY tq credit y 1-1/2% service charge per
2 2 4 ,CUSTOMER SIGNATURE month will be charged on past due balances. T J
1
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))
12/16/09 1293500071 $302.40
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. WARRANT NO.
ALLOWED 20
Midwest Brake Wheel, Inc
IN SUM OF
P. O. Box 2933
Indianapolis, IN 46206 -2933
$302.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Membel
2201 1293500071 42- 370.00 $302.40 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
1 f
mber 22, 200!
Tesday Dece
Street CommissionerV
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund