223574 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 201250 Page 1 of 1
ONE CIVIC SQUARE MID STATE TRUCK EQUIP CORP
CARMEL, INDIANA 46032 11020ALLISONVILLE RD CHECK AMOUNT: $688.00
FISHERS IN 46038 CHECK NUMBER: 223574
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4238000 72919 449 . 00 SMALL TOOLS & MINOR E
2201 4237000 73046 239 . 00 REPAIR PARTS
MID-STATE TRUCK EQUIPMENT Invoice
11020 Allisonville Road Invoice Number:
L x'
Retail#: 001104675-001-0 72919
Fishers, IN 46038
mid.$RIc TrutR Equipfflrnc Invoice Date:
dR�T6tw�T7t3
Phone: 317.849.4903 €--
www.mid-statetruck.com - -- —8/5/2013
Fax : 317.849.6441
Bill To Ship To AUG -- 8 2013
CARMEL CLAY PARKS & RECREATION DAWN
1411 E. 116TH STREET 317.573.4026
Carmel, IN 46032
14 n`dling charge added to Credit Customer P.O. NO. Terms
Card orders over$500.00: 2.5% on
Visa, M/C, AMEX&Discover 30122 NET 25 Days
Sales Rep ID Shipping Method Ship Date Due Date
-
MRR cust. pick-up 8/5/2013 8/30/2013
Qty Item Code Description Price Ea. Extension
1 WB200B BUYERS WALK-BEHIND BROADCAST 399.00 399.00
SPREADER; STAINLESS STEEL FRAME, 100 LB
CAPACITY
1 FREIGHT-01 FREIGHT/SHIPPING 50.00 50.00
--DELIVERY TO CUSTOMER
Serial#
Serial# Subtotal $449.00
Sales Tax (7.0%) $0.00
Received b Total Invoice Amount $449.00
y
Payment Received $0.00
Check#/Authorization Code: ice Due $449.00
Thank y®u fog°your business!
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
201250 Mid-State Truck Equipment, Inc. Terms
11020 Allisonville Road
Fishers, IN 46038
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO # Amount
8/5/13 72919 JVValk behind salt spreader 30122 $ 449.00
Total $ 449.00
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.
201250 Mid-State Truck Equipment, Inc. Allowed 20
11020 Allisonville Road
Fishers, IN 46038
In Sum of$
$ 449.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
INVOICE NO. ACCT#/TITL AMOUNT
Dept#
1093 72919 4238000 $ 449.00 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
22-Aug 2013
signature
$ 449.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
MID-STATE TRUCK EQUIPMENT Y invoice
11020 Allisonville Road _ Invoice Number:
r, '°
, �
Retail#: 001104675-001-0 73046
Fishers, IN 46038 E
i-+ a•sc.�cc rta� qun��+c` Invoice Date:
ltdt<'s:I�.tt t7�ll S
Phone: 317.849.4903 - '#
www.mid-statetruck.com 8/19/2013
rax : s1/.54Y.0441
Bill To - Ship To
C;AKIVILL J 1 Kr,h 1 VbFAK 1 Mr-IN 1
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 ----- ----°�
i
Visa M/C. AMEX&Discover SHOP NET 25 Days.
Sales Rep ID Shipping Method Ship Date Due Date
TMB P 8/19/2013 9/13/2013
Qty I Item Code Description Price Ea. Extension
�1 PARTS FORD 550 NERF BARS 239.00 239.00
1
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serial
Serial# Subtrtal $239.00
Sales Tax (7.0%) $0.00
Total Invoice Amount $239.00
Received by
Payment Received $0.00
Check#/Authorization Code: i Balance Due $239.00
Thank you for your business!
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mid-State Truck Equipment
IN SUM OF $
11020 Allisonville Road
Fishers, IN 46038
$239.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 I 73046 42-370.00 $239.00 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
Vr i ay, ust 23, 2013
,�tregt�ommisg o er
ree ommissioner
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))
08/19/13 73046 $239.00
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