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FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
--11 I FEDERAL EXCISE TAX EXEMPT
35-60000972
PAGE 1
PURCHASE ORDER NUMBER
39007
THIS NUMBER MUST APPEAR ON INVOICES. NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS ANO ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
8/26/2015
08/05/15
6191
Furnace inspection & possible repair at Perelman Property
Ellis Mechanical, Inc.
2929 Bluff Road
VENDOR Indianapolis, IN 46225
SHIP
TO
Parks Maintenance
1427 E. 116th Street ATTN: Courtney
Carmel, IN 46032
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
1.000
Send Invoice To:
each
The upstair furnace's fan runs constantly and will not shut off. $ 343.0000
GLAccount# 1125401-4350100
PLEASE INVOICE IN DUPLICATE
$ 343.00
$ 343.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
C.0.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.
PAYMENT
• AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER 15 MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
AFFIDAVIT ATTACHED.
- I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATEO BALANCE IN THIS APPROPRIATION
SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY Courtney Weintraut
TITLE
CLERK -TREASURER
DOCUMENT CONTROL NO. 39007 VENDOR COPY
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