HomeMy WebLinkAbout31885 AlGalCo, LLCCi
of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
veCIATIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
31885
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
10/29/2014
VENDOR
AIGaICo, LLC
P.O. Box 502768
Indianapolis, IN 46250
SHIP
TO
Street Department
3400 W. 131st Street
Carmel, IN 46074
(317) 733-2001
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 0043 - 509.00
1 Each Hydrogen Fuel System
Send Invoice To:
Street Department
3400 W. 131st Street
Carmel, IN 46074-
PLEASE INVOICE IN DUPLICATE
$5,000 00
Sub Total:
$5,000.00
$5,000 00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Carmel Street Department
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY
TITLE
PAYMENT $5,000.00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED,
I HEREBY CERTIFY THAT THERE IS AN yNOBLIGATED BALANCE IN
•
THIS,A @PROPRIATIpN SUFFICIENT TO1PAY FOR THE ABOVE ORDER,
cfieel Co
/fr., /5.5 /co -P c
DOCUMENT CONTROL NO. 31 H $ 5 CLERK- TREASURER
A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE