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City of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100893
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
11/9/2017 361637 Spill Pad-CTC
FREDERICKS CONTRACTORS Fire Department
VENDOR PO BOX 229 SHIP 2 Civic Square
TO Carmel, IN 46032-
PENDLETON, IN 46064-
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
20564
QUANTITY r- UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
•
Department: 1120 Fund: 101 General Fund
Account: 43-501.00
1 Each 30 x 30 Concrete Pad with 20 mil barrier and PVC Welded $13,200.00 $13,200.00
Liner
Sub Total $13,200.00
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT i ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $13,200.00
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 1945r44--e
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY -- \
Denise Snyder James Crider
tk
TITLE Budget&Accreditation Manager Administration
CONTROL NO. 100893 CLERK-TREASURER