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IIit)T ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 33451
ONE CIVIC SQUARE 35-6000972 - THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
CARMEL, INDIANA 46032 2584 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
2/4/2016 068025
CROSSROAD ENGINEERS,PC Engineering
VENDOR 3417 S SHERMAN DR SHIP 1 Civic Square
TO Carmel, IN 46032-
BEECH
GROVE, IN 46107- Kate Lustig
', PURCHASE ID BLANKET CONTRACT I PAYMENT TERMS i FREIGHT —I
j 2397
QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE 1 EXTENSION
Department: 2200 Fund: 2200 Motor Vehicle Highway
Account: 43-401.00
1 Each 2016 On-Call Plan Review $105,000.00 $105,000.00
Sub Total $105,000.00
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PSA- 23.-
Ori91hOA1 Ary- 4 $0,000
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1 rrc0-:ed : 425, 000
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P O. 21,45 I
tc,i 42S, 000
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Send Invoice To:
Engineering
Kate Lustig
1 Civic Square
Carmel, IN 46032-
-.-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $105,000.00
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 ........ . x'c---
Cl--� / � `?
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. - - —
Jeremy Kashman Douglas Haney
TITLE Director Cornnratinn Cot nsal