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®- Cade y}� el CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
,j ll FEDERAL EXCISE TAX EXEMPT 100950
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
1FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
,PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/13/2017 366795 Carmel Drive/AAA Way Road Work Improvements
H W C ENGINEERING Dept of Community Service
VENDOR 601 SOUTH 3RD ST SHIP 1 Civic Square
TO Carmel, IN 46032-
TERRE HAUTE, IN 47807-
PURCHASE ID BLANKET . CONTRACT PAYMENT TERMS FREIGHT
20634
QUANTITY 1 UNIT OF MEASURE t DESCRIPTION UNIT PRICE 1 EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-509.00
1 Each Road Work Improvement $25,870.00 _ $25,870.00
Sub Total $25,870.00
Send Invoice To:
Dept of Community Service Reduced VS Eng PO to$0,switched to this vendor
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT y 9 PROJECT PROJECT ACCOUNT AMOUNT ,
PAYMENT $25,870.00
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 794,7 %—e 15.- 1- 4`-"e 'C'i
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY --- ----- — \�
Mike Hollibaugh James Crider (U
TITLE Director Administration \ \' ✓A
CONTROL NO. 100950 CLERK-TREASURER \ °'`VVI