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a INDIANA RETAIL TAX EXEMPT Page 1 of 1
Iit ®� Iiriinnie1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100615
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. 1 VENDOR NO. DESCRIPTION
— 116th St.,east of Hazeldell-Bed Maintenance
7/26/2017 1 128350
1
HITTLE LANDSCAPING, INC 74 Street Department
VENDOR 17778 SUN PARK DR SHIP 3400 W. 131st Street
TO
1 Carmel, IN 46074-
WESTFIELD IN 46074- (317)733-2001
PURCHASE ID 1 BLANKET CONTRACT ; PAYMENT TERMS FREIGHT
17591
QUANTITY i UNIT OF MEASURE DESCRIPTION i UNIT PRICE EXTENSION
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account: 43-504.00
1 Each 116th St.,east of Hazeldell-Bed Maintenance $501.82 $501.82
Sub Total $501.82
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Send Invoice To: # ; M ..
Street Department
3400 W. 131st Street
Carmel, IN 46074- 3
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT — PROJECT PROJECT ACCOUNT
PAYMENTAMOUNT
$501.82 ✓
*A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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 APPEARALL SHIPPING LABS OC.. /411---"gt
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY ---
Dave Huffman
TITLE Director
CONTROL NO. 100615 CLERK-TREASURER