211866 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 202000 Page 1 of 1
0 ONE CIVIC SQUARE MIDWEST BRAKE&WHEEL, INC CHECK AMOUNT: $179.08
CARMEL, INDIANA 46032 PO BOX 2933
INDIANAPOLIS IN 46206-2933 CHECK NUMBER: 211866
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 1221700105 -48 . 00 REPAIR PARTS
2201 4237000 1222070010 227 . 08 REPAIR PARTS
'--� S77�EK4ENTOFACCOUNT
AQ SOUTH MI BRAKE & WHEEL . INC-
WEST 3TREET
IS IN 46225
EL ACCT : 10099 *1*
'STREET/DE PT
SOLD---34UU 1ST STREET
TO -`#�3TFTELD IN 46074
NOTICE.SEE REVERSE SIDE FOR IMPORTANT INFORMATION REGARDING FINANCE CHARGES AND YOUR BILLING RIGHTS
,�TOTAL OPEN IlTEMS 179. 08
WE ARE NOWiFLEETPRIDE !," 250 STORES AND MU i CH MORE
IN.V-EN-T-O.IR.Y-'l-i'-DRI-VELINE , TRANSMISION AND. BRAKES :
30 60-90 DAYS TOVER 90 DAYS TPTA D.t�B
0 1!
INVOICE DATE
MIDWEST BRAKE HEEL, INC.
07/25/2012
INVOICE NO. PAGE
1140 S,West Street P.O.Box 2933
INDIANAPOLIS, IN 46206-2933 1222070 01 0 1
1 Phone: (317) 632-4487 CUSTOMER NO. BRANCH
www.mwbrake.com 1 0 0 9 9 1
SOLD C I TY OF CARMEL SHIP C I1"Y OF CARMEL
TO STREET DEPT TO STREET DEPT
3400 W 131ST STREET 3400 W 131ST ST"RE"ET
WESTFIELD IN 46074 WESTFIEL_D IN 46074
PLEASE REMIT TO: P.O. BOX 2933 INDIANAPOLIS, IN 462064933
CUSTOMER P.O. R/S ORDER NO.
TRLJCK200 996056 MON 317 733-2001 JL 001 /00 001
QUANTITY I PART NO. I PRICE/PER I EXTENSION
**THIS IS A BACKORDER SHIPMENT**
4 MER A13-236Q2123 ROCKWELL DUST SHIELD;- 94 . 61 56 .77EA 227 .08
############################
OUR DELIVERY OUR DELIVERY
############################
ORDER PICKED BY : LS/JB
EFFECTIVE 5/1 /2010 WE WILL NO LONGER GROUP 4515Q
. CORES WITH 4707QP CORES. ASK YOUR SALESMAN
CORES MUST BE RETURNED WITHIN 90 DAYS.
FREIGHT TAXABLE SUBTOTAL TAX STATUS/STATE I SALES TAX PLEASE PAY
227 . 08 E IN 0 . 00 227 . 08
PAYMENT TERMS:open accounts due and payable on or before the 10th day of the month following the
date of purchase.Any account l cftj jt�tese IjGrm�yill e ubj>;ct;to�{e t,11QIcJ.A 1-1/2%service charge per
CUSTOMER SIGNATURE month will be charged on past u es. V I V I �'j h' �.J X
08 : 26 AM INE00000NYYY-0/INT00000-7
2-JUL-2012 10:34 Gold-Fax Message Page 212
1
MIDWEST BRAKE& WHEEL, INC. INVOICE DATE
06/18/2012
INVOICE NO PAGE
1221700105 1
CUSTOMER NO BRANCH
10099 * 1*
SOLD CITY OF CARMEL SNIP CITY OF CARMEN,
T0,
STREET DEPT STREET DEPT
To: 3400 W 131ST STREET 3400 W 131ST STREET
WESTFIELD IN 46074 WESTFTELD IN 46074
CUSTOMER PO REFERENCE NO
4- LS CLASSQP-C1 CORE ROCKWL 4707QP 16.5x RET 12.00EA 48.0008
#########################
CORE CREDIT / CORE CREDIT
CORE CREDIT / CORE CREDIT
#########################
ORDER PICKED BY: MB
EFFECTIVE 5/1/2010 WE WILL NO LONGER GROUP 4515Q
CORES WITH 4707QP CORES. ASK YOUR SATESmAN
F 41 TA SAILESTAX p
48.00CR E IN 0.00 48.00CR
TE FMS
(00) CREDIT MEMO
05:26 PM INEOOOOONYYY-0/INT00000-7
VOUCHER NO. WARRANT NO.
ALLOWED 20
Midwest Brake & Wheel, Inc
IN SUM OF $
P. O. Box 2933
Indianapolis, IN 46206-2933
$179.08
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 1221700105 42-370.00 ($48.00) 1 hereby certify that the attached invoice(s), or
2201 1222070010 42-370.00 $227.08 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
B r
/Thursday A'/9 ust 09, 2012
/
VV
St eetPom�mission e',r
Title
Cost distribution ledger classification if
claim paid motor 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 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))
06/18/12 1221700105 ($48.00)
07/25/12 1222070010 $227.08
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