214382 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 228000 Page 1 of 1
ONE CIVIC SQUARE NORTHSIDE TRAILER INC. CHECK AMOUNT: $322.85
CARMEL, INDIANA 46032 11985 EAST STATE ROAD 32
ZIONSVILLE IN 46077 CHECK NUMBER: 214382
CHECK DATE: 1117/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 121140 322 . 85 OTHER EXPENSES
N®R'T"HSIDE TRAILER LLC
SALES • PARTS • SERVICE
INVOICE NO.
11985 EAST STATE ROAD 32 121140
ZIONSVILLE, IN 46077
317-769-2460
317-769-2463 FAX
BILL TO: 14234 SHIP TO:
CITY OF CARMEL - UTILITIES
WATER/SEWAGE DEPTS .
760 THIRD AVE . S . W. 760 THIRD AVE . S . W.
CARMEL, IN 46032 CARMEL, IN 46032
(317) 571-2400
Pa e: 1
INVOICE DATE ORDER NO. TERMS - SALESPERSON
Oct25 ' 12 JIM HAAG NET 30 DAYS KENT KENT
QUANTITY DESCRIPTION UNIT PRICE AMOUNT
2 182900 23-105 69 . 50 139 . 00
BRK ASM 12x2 LH 6K DEXTER
2 183000 23-106 69 . 50 139 . 00
BRK ASM 12x2 RH 6K DEXTER
4 159700 10-36 3 . 00 12 . 00
GREASE SEAL, 3 . 376ODx2 .25ID
3 435800 426KR 10 . 95 32 . 85
STOP, TURN, TAIL LIGHT, SEALED
�J
Sub-Total 322 . 85
Discount
Shipping & Handlinc 0 . 00
Tax[ 01 EXEMPT*
Tota 322 . 85
ount Paid 0 . 00
Receive B 7 Amount Due 322 . 85
Change 0 . 00
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
228000
NORTHSIDE TRAILER INC. Purchase Order No.
969 N RANGELINE RD Terms
CARMEL, IN 46032 Due Date 10/29/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/29/201, 121140 $322.85
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
l i/l l l
Date Officer
VOUCHER # 122550 WARRANT # ALLOWED
228000 IN SUM OF $
NORTHSIDE TRAILER INC.
969 N RANGELINE RD
CARMEL, IN 46032
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
121140 01-6500-05 $322.85
Voucher Total $322.85
Cost distribution ledger classification if
claim paid under vehicle highway fund