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INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
i� _ PURCHASE ORDER NUMBER
f V{• �� FEDERAL EXCISE TAX EXEMPT 52050
35-60000972
OHE CMC SQUARE
CA,R14EL,!NDI=..$LA 4€032-2ES4 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
10/15/2018 09/24/18 17695 00351085 Park Maintenance Outdoor Park Signs
Media Factory Parks Maintenance
481 Gradle Drive 1427 E. 116th Street ATTN: Courtney
VENDOR Carmel, IN 46032 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
45.000 each Theft prevention signs-24 x 18 $31.5000 $ 1,417.50
20.000 each Habitat restoration signs- 12 x 18 $26.0000 $520.00
GLAccount#1125401-4239031
Send Invoice To:
$ 1,937.50
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• A/P 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Michael Allen
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE \\
CLERK-TREASURER W \\\
DOCUMENT CONTROL NO. 52050 VENDOR COPY Q ,