215557 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 008050 Page 1 of 1
h ONE CIVIC SQUARE ACTION EQUIPMENT INC
' CARMEL, INDIANA 46032 5801 S.HARDING ST CHECK AMOUNT: $683.75
INDIANAPOLIS IN 46217 CHECK NUMBER: 215557
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232100 PSI12-10355 683 . 75 GARAGE & MOTOR SUPPIE
Remit to:
Harding Street
58th Invo i c e
Indianapolis,polis,IN 46217
(317)788-9781 INDIANAPOLIS
EOUIPMENT SALES CO.,INC. (812)423-7974 EVANSVILLE (502)964-4464 LOUISVILLE
INVOICE NUMBER: PS112-10355
INVOICE DATE: 11/15/12
PAGE:_
SOLD CARMEL UTILITIES SHIP CARMEL STREET DEPT -WESTFIEL
To: WASTEWATER TO: 3400 W. 131 ST STREET
760 THIRD AVE. SW, SUITE 110 CARMEL, IN 46074
CARMEL, IN 46032
> - CUSTOMER I.D.: CARM01
SHIPvIA: DELIVER OUR TRUCK P.O.NUMBER:
SHIP DATE: P.O.DATE: 11/14/12
DUE DATE: 11/25/12 OUR ORDER NO.: S012-10654
TERMS: Net 10 days SALESPERSON: CO2 - MIKE PETRISKEY
ITEM/DESCRIPTION UNIT ORDER OTY QUANTITY UNIT PRICE TOTAL PRICE
117-IP BREAKTHROUGH PLUS GALLONS 125 125 5.25 656.25
HAZMAT/DELIVERY CHARGE EACH 1 1 27.50 27.50
(ONLY FILL 125 GALLONS)
AMOUNT SUBJECT AMOUNT EXEMPT SUBTOTAL:.
TO SALES TAX FROM SALES TAX INVOICE DISCOUNT: 683.75
SALES TAX: 0.00
0.00 683.75 0.00
INVOICE TOTAL:
683.75
PAST DUE ACCOUNTS SUBJECT TO 1.5% SERVICE CHARGE PER MONTH
VOUCHER NO. WARRANT NO.
ALLOWED 20
Action Equipment
IN SUM OF $
5801 S. Harding Street
Indianapolis, IN 46217
$683.75
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I PS112-10355 I 42-321.001 $683.75 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 t f2
'F/ayJDece�br14, 2012
StrcS'96RCommissibner
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))
11/15/12 PS112-10355 $683.75
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