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}1cf Iairiiiriie1 CERTIFICATE NO.003120155 0020 PURCHASE ORDER NUMBER
//Jl FEDERAL EXCISE TAX EXEMPT 101751
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
612512018 060650 INDOT LPA Des 1401703,Des 1801435-Construction Inspection
CLARK DIETZ, INC City Engineering's Office
VENDOR 8900 KEYSTONE CROSSING#900 SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46240 - Kate Lustig
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
27009
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Fund: 203 CUM Cap Improvement Fund
Account: 43-509.00
1 Each Des 1401703-1801435-126th Street Path-Construction $40,146.40 $40,146.40
Inspection
Sub Total $40,146.40
Department: 2200 Fund: 900 Grant Fund
Account: 43-590.41
1 Each Des 1401703-1801435-126th Street Path -Construction $160,585.60 $160,585.60
Inspection
Sub Total $160,585.60
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Send Invoice To:
City Engineering's Office
Kate Lustig /
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $200,732.00
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 A"-47
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jeremy Kashman James Crider
TITLE Director Administration
CONTROL NO. 101751 CLERK-TREASURER