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City of Carmel
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100450
ONE CIVIC SQUARE 35-6000972 _ THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584
VOUCHER,DELIVERY MEMO.PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
5/1812017 364088
CONCRETE TAILORS LLC Street Department
VENDOR PO BOX 3 SHIP 3400 W. 131st Street
TO Carmel, IN 46074-
NOBLESVILLE, IN 46061 - (317)733-2001
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
15467
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account: 43-509.00
1 Each Insurance Reimbursement Rangeline Rd./136th St. $2,675.00 $2,675.00
Sub Total $2,675.00
Send Invoice To:
Street Department
3400 W. 131st Street
Carmel, IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT _ ACCOUNT PROJECT _ PROJECT ACCOUNT ' AMOUNT
PAYMENT $2,675.00
SHIPPING INSTRUCTIONS '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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 _� -i.
4, 4`` `/)r
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. I,
Dave Huffman w`
ORDERED BY
TITLE Director
CONTROL NO. 100450 CLERK-TREASURER