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City ^ C , CERTIFICATE NO.003120155 002 0 I( '{ � a _ `_`J j� FEDERAL EXCISE TAX EXEMPT 38447
35-60000972
I'I ITS NUMITER MUST APPEAR ON INVOICES,A/R
-- -` VOUCHER,DELIVERY MEMO,PACKING SLIPS.
SI III'I'ING LAI3I1).S AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEI-- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
5/8/2015 05/12/15 5119 Wilfong Accoulic Panel Materials
Fashion Architectural Designs Administration Office
4005 Carnegie Avenue 1411 E. 116th Street
VENDOR Cleveland, OI-i 44103 SHIP Carmel, IN 46032
CONI'IRMA IION I BLANKET CONIRACI - PAYMENT ITIRMS -_ PRLIGIU
QUANTITY Il1NIT OF MEASURE I DESCRIPTION I UNIT PRICE EXTENSION
1.000 each Accoustic Panel Materials for Wilfong Pavilion per attached $ 11,176.0000 $ 11,176.00
quote
GLAccountt/ 1060000-5023990
Send Invoice To:
$ 11,176.00
PLEASE INVOICE IN DUPLICATE
DEPARTMEN r ACCUUNI PROJECT PROJECT ACCOUNT AMOUN I
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART OF THE VOUCHER ANL)EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
. I HEREBY CERi1FY TIIAT THERE IS AN UNOBLIGA TED BALANCE IN THIS APPROPRIATION
• SI III'!ii_I'AID SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C 0.1)SHIPMENTS CANNOT BE ACCEI'TED.
• PIIPCI IASI'ORDER NUMBER MUST APPEAR ON ALL SKIPPING IAHELS. ORDERED BY pp _J
Dawn Koepper -,^1 � g 1 1
IIiIS 0/115E1/ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
• AND AC IS AMIENDA IVORY H IEREOF AND SUPPLEMI/N F I i IERET O.
TITLE
CLERK-TREASURER
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DOCUMENT CONTROL NO. 38447 t.Ta ' 's