HomeMy WebLinkAbout53611 PAVEMADE LLC INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
o C
acme� PURCHASE ORDER NUMBER
�,/ FEDERAL EXCISE TAX EXEMPT 53611
35-60000972
ONE CMC SQUARE
CARMEL INIDIANA 4-S032-25B= THIS NUMBER MUST APPEAR ON INVOICES,AM
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
10/1/2019 09/23/19 21474 372904 Crack fill supplies
Pavemade LLC Parks Maintenance
106 1/2 Judge John Aiso Street#302 1427 E. 116th Street ATTN: Courtney
VENDOR Los Angeles,CA 90012 To P Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each 1/2 Pallet Right Pointe Crack Sealant(900 Ibs) $ 1,240.000 $1,240.00
GLAccount#1125404-4350100
Send Invoice To:
$ 1,240.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 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 Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER 0\
DOCUMENT CONTROL NO. 53611 VENDOR COPY