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Cit yo-f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102110
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
(1---, CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
( ,___)210 APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/1412018 068025 2019 On-Call Plan Review;Contract Date 02.07.18
CROSSROAD ENGINEERS, PC City Engineering's Office
VENDOR 3417 S SHERMAN DR SHIP 1 Civic Square
TO Carmel, IN 46032-
BEECH GROVE, IN 46107- Kate Lustig
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
30995
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2200 Fund: 202 Local Road &Street Fund
Account: 43-401.00
1 Each ASA 2-2019 On-Call Plan Review $37,900.00 $37,900.00
Sub Total $37,900.00
Department: 2200 Fund: 2200 Motor Vehicle Highway
Account: 43-509.00
1 Each ASA 2-2019 On-Call Plan Review $22,100.00 $22,100.00
Sub Total $22,100.00
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Send Invoice To: .a.
City Engineering's Office
Kate Lustig ., I
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT 1 AMOUNT
PAYMENT $60,000.00
'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
IP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
A).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 �^ C�— _ "
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jeremy Kashman James Crider
TITLE Director Administration \
CONTROL NO. 102110 CLERK-TREASURER \• \