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Cty O1 (.. a rm el CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100663
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
811712017 068025 Project 16-ENG-80;Contract Date 03.16.16
CROSSROAD ENGINEERS, PC City Engineering's Office
VENDOR 3417 S SHERMAN DR SHIP Civic Square
TO Carmel, IN 46032-
BEECH GROVE, IN 46107- Kate Lustig
PURCHASE ID BLANKET I CONTRACT PAYMENT TERMS FREIGHT
18229
QUANTITY + UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
Department: 2200 Fund: 912 Rainy Day Fund
Account: 44-707.00
1 Each ASA 26-River Road Phase II-Construction Inspection and $421,000.00 $421,000.00
Staking Services
Sub Total $421,000.00
Send Invoice To:
City Engineering's Office
Kate Lustig
1 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
r DEPARTMENT ACCOUNT PROJECT ' PROJECT ACCOUNT AMOUNT
PAYMENT $421,000.00
'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 APPEAR ON ALL SHIPPING LABEL !7 '
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 — G
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY — - -
Jeremy Kashman James Crider (�
TITLE Director Administration
CONTROL NO. 100663 CLERK-TREASURER - _