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Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
INDIANA RETAILTAXEXEMPT Page 1 of 1
11r ®- FEDERAL EXCISE TAX EXEMPT 1 02
142
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
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:PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
�~ 11/20/2018 372951
1 RICHARD H FEIGH
Dept of Community Service
IVENDOR 18 THORNHURST DR SHIP 1 Civic Square
TO Carmel, IN 46032-
CARMEL, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31231
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-590.29
1 Each Façade Grant $200.70 $200.70
Sub Total $200.70
SCANNED
NOV 21 2018
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Send Invoice To: F
Dept of Community Service ', ,,r
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $200.70
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 0.D SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELf6.70
'
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 Q,ev
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY a
Mike Hollibaugh
TITLE Director
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CONTROL NO. 19.?142 CLERK-TREASURER
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