HomeMy WebLinkAbout41444 MOST DEPENDABLE FOUNTAINS INC. INDIANA RETAIL TAX EXEMPT PAGE 1
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PURCHASE ORDER NUMBER
..cy o ( a.rrriei I CERTIFICATE ND.0031201550020FEDERAL EXCISE TAX EXEMPT 41444
3540000972
CARPEL*CANA 44032- St THIS ONE CNC SQUARE ANSIVOUCHER.NUMBERANSI
MEPMPACKING�
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1897
PURCHASE ORDER DATE DATE RFOUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
4/27/2017 04/30/17 12313 354037 Drinking fountain repair parts for Lenape and stock to keep on
hand
Most Dependable Fountains Inc. Parks Maintenance
P.O.Box 587 1427 E. 116th Street ATTN:Courtney
VENDOR Arlington,TN 38002-0587 SHIP Carmel, IN 46032
CONFIRMATION BLMMIET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY _UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each 114"x42"hose $22.0000 $22.00
1.000 each 1/4"x114"ball seat adapter ss $4.0000 $4.00
1.000 each 1/8"x1/8"ball seat adapter ss $4.0000 $4.00
1.000 each 114"x1/8"ball seat adapter ss $4.0000 $4.00
2.000 each 1/4"x20"hose $18.0000 $36.00
3.000 each repair kit for valve body III $14.0000 $42.00
2.000 each 305B KIT $27.0000 $54.00
3.000 each o-ring assembly $49.0000 $ 147.00
1.000 each VBIII adjustable kit $98.0000 $98.00
1.000 each shipping $17.0000 $17.00
GLAccount#1125412-4237000
Send Invoice To:
APR 2 7 2017 $428.00
64BY: PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMBIT
PAYMENT
• AlP 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
. I HEREBY CERTIFY THAT THERE IS AN UNOBUOATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.OD SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBERMUST APPEAR ONALL SHIPPING LABELS. ORDERED BY Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER .\kk
DOCUMENT CONTROL NO. 41444 VENDOR COPY