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CERTIFICA EENO00310150020 PURCHASE ORDER NUMBER
//Jj FEDERAL EXCISE TAX EXEMPT 101111
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 372129
SI-H INTERNATIONAL CORP Redevelopment Department
VENDOR 290 DAVIDSON AVE SHIP 30 W.Main Street,Suite 220
TO Carmel, IN 46032-
SOMERSET, NJ.08873 Michael Lee ' (317)571-2788
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21758
QUANTITY ,UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1801 Fund: 101 General Fund
Account: 44-632:02
1 Each phbeI9001. Phantom PDF Business 9 • $341.43 . $341.43
Sub Total $341.43
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Send Invoice To: ,
Redevelopment Department �`
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Michael Lee
30 W MainStreet,Suite 220
Carmel,IN 46032-
(317)571-2788 PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $341.43
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 d' `---'�' 1ZI _ - '
ORDERED BY t
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. I
Henry Mestetsky
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CONTROL NO. 101111 CLERK-TREASURER