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City ®f Carmel I CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100793
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
10/12/2017 068025 Project 15-15;Contract Date 03.16.16
CROSSROAD ENGINEERS, PC City Engineering's Office
VENDOR 3417 S SHERMAN DR SHIP 1 Civic Square
TO Carmel, IN 46032-
BEECH GROVE, IN 46107- Kate Lustig
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
19783
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Fund: 202 Local Road &Street Fund
Account: 43-401.00
1 Each ASA 30-Guilford Road-City Center Drive to Main Street- $64,733.80 $64,733.80
Supplemental
Sub Total $64,733.80
Send Invoice To:
City Engineering's Office
Kate Lustig
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE _
DEPARTMENT ACCOUNT PROJECT J PROJECT ACCOUNT -MOUNT
PAYMENT $64,733.80
SHIPPING INSTRUCTIONS A/P 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
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jeremy Kashman James Crider
TITLE Director Administration
CONTROL NO. 100793 CLERK-TREASURER \)\