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City ®f Carrriel INDIANA RETAILOTAX EXEMPT Page 1 E 7
CERTIFICATE NO.003120155 002 0PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100976
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/29/2017 361637 Station 42 Concrete Work
FREDERICKS CONTRACTORS Fire Department
VENDOR PO BOX 229 SHIP 2 Civic Square
TO Carmel, IN 46032-
PENDLETON,IN 46064,-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21031
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120' Fund: 102 Ambulance Capital Fund
Account: 43-501.00
1 Each Clean:existing joints
"and re-apply sealant
$3,600.00 ,600.00
Sub Total
$3,600.
$3 00
S, , , -:, -1
CANNED
NOV 2 9 2 X17
4
a
Send Invoice To.,
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT PROJECT PROJECT ACCOUNT n AMOUNT
PAYMENT $3,600.00
SHIPPING INSTRUCTIONS 'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
'SHIP PREPAID. PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
;cap.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
ORDERED BY
` ' •�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. \
Denise itatio /
TITLE Budget&Accreditation
Manager ,V\
CONTROL NO. 100976 CLERK-TREASURER