HomeMy WebLinkAbout101151 MICHAEL & JUDITH JOHNSON INDIANA RETAIL TAX EXEMPT Page 1 of 1
Citi of iIarrrie10ERTIFICATE
EXCISE TAX EXEMPT PURCHASE PURCHASE �N UMBER
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
12/14/2017 372140
MICHAEL&JUDITH JOHNSON Dept of Community Service
VENDOR 11932 PEBBLEBROOK LANE SHIP 1 Civic Square
TO Carmel,IN 46032_
CARMEL,IN 46032-
PURCHASE IDBLANKET CONTRACT PAYMENT TERMS FREIGHT
21832
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-590.29
1 Each Façade Grant $2,818.71 $2,818.71
Sub Total $2,818.71
`
a x*`
Send Invoice To:
Dept of Community Service
1 Civic Square '
Carmel, IN.46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT V PROJECT ACCOUNT B AMOUNT
PAYMENT $2,818.71
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
*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 1
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 �/ 5- .1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY �/
Mike Hollibaugh \ V'
TITLE Director \�\`
CONTROL NO. 101151 CLERK-TREASURER