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ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
32179
THIS NUMBER MUST APPEAR ON INVOICES, PIP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
9/22/2014
•
VENDOR
VS Engineering, Incl.
4275 North High School Road
Indianapolis, IN 46254
SHIP
TO
DOCS Department
1 Civic Square
Carmel, IN 46032
(317) 571 -2418
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43- 509.00
1 Each West Carmel Drive Path Project
Send Invoice To:
DOCS Department
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$7,000.00 $7,000.00
Sub Total: $7,000.00
DEPARTMENT
1192 DOCS
ACCOUNT
PROJECT
PROJECT ACCOUNT I AMOUNT
PAYMENT $7,000.00
• AIP 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 THIS AP OOPRIA ION¥IFCIEf fTO OA THE) VE ORDER.
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
Director
CLERK - TREASURER
DOCUMENT CONTROL NO. 32179 A.P.V. COPY -SIGN AND RETURN TO CLERK'S OFFICE