HomeMy WebLinkAbout215709 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 201250 Page 1 of 1
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP CHECK AMOUNT: $230.00
fsk' CARMEL, INDIANA 46032 11020 ALLISONVILLE RD
FISHERS IN 46038 CHECK NUMBER: 215709
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 69627 230 . 00 REPAIR PARTS
MID-STATE TRUCK EQUIPMENT Invoice
11020 Allisonville Road Invoice Number:
Retail#: 001104675-001-0
69627
Fishers, IN 46038
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Invoice Date:
Phone: 317.849.4903
Fax : 317.849.6441 www.mid-statetruck.com 12/7/2012
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$500.00: 2.5% on
Visa, MIC, AMEX&Discover WILLDAVIS NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
............-
CAG cust. pick-up 12/7/2012
1/1/2013
Qty Item Code Description Price Ea. Extension
..................... ....................-............................. ............__.............
2 PARTS1 22-1100-00 TIRES 115.00 230.00
..................... -------
Serial#
Serial# Subtotal $230.00
Sales Tax (7.0%) $0.00
Received by Total Invoice Amount $230.00
Payment Received $0.00
Check#/Authorization Code: Due .�$230.00
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I hank y®u for your business!
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid-State Truck Equipment
IN SUM OF $
11020 Allisonville Road
Fishers, IN 46038
$230.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 69627 I 42-370.00) $230.00 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
Friday;Dece. r-14;2012
Street Commissioner
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))
12/07/12 69627 $230.00
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
20
Clerk-Treasurer