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C lt ®f Ia.]rrrJIe1CINDIANA RETAIL TAX EXEMPT FEDERAL EXCISE TAX EXEMPT 35-6000972
PURCHA�S®ORDE�R�UMBER
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
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
12/14/2017 372141
ROBERT&PAMELA AVENIUS Dept of Community Service
VENDOR 45 THORNHURST DRIVE SHIP 1 Civic Square.
TO
Carmel,IN 46032-
CARMEL, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21833
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-590.29
1 Each Façade Grant
$445.41 .: $445.41
Sub Total $445.41
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Send Invoice To:
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Dept of Community Service
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT [ ACCOUNT PROJECT V PROJECT ACCOUNT AMOUNT
PAYMENT $445.41
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
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /9f,..,,,,,, ,,e.,5,--„r,,
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Mike Hollibaugh
TITLE Director \\ i
CONTROL NO. 101153 CLERK-TREASURER *