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317876 10/31/2017 � Coq c "f CITY OF CARMEL, INDIANA VENDOR: 00351585 ONE CIVIC SQUARE BLUE GRASS FARMS, INC. CHECK AMOUNT: $"""'1,380.00` ,1 ?� CARMEL, INDIANA 46032 1915 W.53RD STREET CHECK NUMBER: 317876 +*. ANDERSON IN 46013 CHECK DATE: 10/31/17 < <iON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4462400 100856 110490 1,380.00 TREES � om � O k / A O > X k G) n q a X # m m k(D: C z 0 / J m z -n 2 0 1 � Cl) > a O o k m Cl) $ 3 0 PCD 0 � _ > 0 / § k C q Cl) ;o a (D m 8 © CD 0� > n O . � p E q | 8 R > a i _ r g + a k k ° - cr o m c 2 0 7 k n Q � k k c 9 o O ' 2 0 - CR c $ § , g E § / c o g =r fI [ \ @ § a - # ; ® CL / _E § Cl , + 3 | o (D kI $ mo 7 J �ƒ k ) q \ » \ . ■ g ® ® � ® k i # s D / ¥ g - 0 E < j CD 0 / z 9 # ] 0 k �� ■ � m 2 = C 2 / o e © CD g $ Z \ CD I \ [ .. 06D / ( Ci"0. 0 > -.8 ; = Co ' 0 > w ; K > Co CD \ k 0 \ R # n k $ o U § # O z CD C / � , c , Q 2 0 / © o 2 \ Izk A -n\ k k \ ( \ 69 > t g § 0 k a C INVOICE Page aim 1915 W 53rd St Transaction# 110490 Anderson, IN 46013 (800)346-0272 Order Date 09/29/17 (765)649-1012 Ship Date 10/25/17 Invoice Date 10/26/17 Terms/Payment Net 30 PO Number 100066 �--- Record# 3DK8 Sold To: Ship To: City of Carmel/Dept of Community Devel. TMT Nursery One Civic Square 1719 West 161st Carmel IN 46032 Westfield IN 46074 Comment Suzy Dubois 317-867-3691 Item Size Ordered Shipped Back Order Unit Price Amount YELLOWOOD 1.75" 10.00 10.00 0.00 122.0000 1,220.00 Cladrastis kentukea FREIGHT CHARGE 1.00 1.00 0.00 160.0000 160.00 ao 11.00 11.00 0.0000 **A$30 fee will be charged for any NSF check Check# Item Total 1,380.00 Discount 0.00 Sales Tax 0.00 THANK YOU FOR YOUR B USINESS Total Amount : 1,380.00 Signature : Payments 0.00 Balance Due 1,380.00 �KA mAN 00� ity INDIANA RETAIL TAX EXEMPT Page 1 of 1 �j CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER of Carme FEDERAL EXCISE TAX EXEMPT 100856 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 I REQUISITION NO. VENDOR NO. DESCRIPTION 10/26/2017 00351585 BLUE GRASS FARMS, INC. Dept of Community Service VENDOR 1915 W. 53RD STREET SHIP 1 Civic Square TO Carmel, IN 46032- ANDERSON, IN 46013- I PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT i ' 20156 ~ QUANTITY - UNIT OF - - - MEASURE DESCRIPTION UNIT PRICE I EXTENSION Department., 1192 Fund: 101 General Fund Account., 44-624.00 1 Each Trees $1,380.00 $1,380.00 Sub Total $1,380.00 CppY {' 7s i i x s` Send Invoice To: - - Dept of Community Service 1 Civic Square Carmel, IN 46032- PLEASE INVOICE IN ATE DEPARTMENT ACCOUNT PROJECT PROJECTACC-0UNT AMOUNT j PAYMENT $1,380.00 SHIPPING INSTRUCTIONS AIP 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 Jp 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY - - -- - --- ---- --- Mike Hollibaugh TITLE Director CONTROL NO. 100856 CLERK-TREASURER