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I o f Carme1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 1 03399
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
12/10/2019 372629 Building Repairs/maintenance
FREDERICKS, INC ICS
VENDOR 5448 W.ST. RD#132 SHIP 31 1st Avenue N.W.
TO Carmel,IN 46032
PENDLETON,IN 46064- Timothy Renick (317)571-2576
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
42385
QUANTITY UNIT OF MEASURE - DESCRIPTION UNIT PRICE EXTENSION
Department: 1115 Fund: 101 General Fund
Account: 43-5. 01.00
1 Each Building Repairs/Maint $4,500.00 $4,500.00
Sub Total $4,500.00
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Send Invoice To: '' ,', :-
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Timothy Renick moo"
31 1st Avenue N.W.
Carmel, IN 46032-
(317)571-2576
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT w PROJECT PROJECT ACCOUNT W AMOUNT
PAYMENT $4,500.00
SHIPPING INSTRUCTIONS 'ASP 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 ./
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Timothy Renick
TITLE Director
CONTROL NO. 103399 CLERK-TREASURER