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ciitCity ®f IIirrnie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103604
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
12/23/2019 372357 EXPENSE REPORT ITEMS
FIFTH THIRD BANK-PCARD ONLY Community Relations
VENDOR NO ADDRESS-ACH SHIP 1 Civic.Square
TO Carmel, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
42896
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1203 Fund: 101 General Fund
Account: 43-465.00
1 Each EXPENSE REPORT ITEMS $200.00. $200.00
Sub Total $200.00
Account: 43-552.00 .
1 Each EXPENSE REPORT ITEMS $258.99 $258.99
Sub Total $258,99
Account: 43-590.00
1 Each EXPENSE REPORT ITEMS $224.66 $224.66
Sub Total $224.66
Account: 43-590.03
1 Each EXPENSE REPORT ITEMS $1,459.31 $1,459.31
;': Sub Total $1,459.31
Account: 43-593.00
1 Each EXPENSE RE ORtITEMS .' $63.76 $63.76
Sub Total $63.76
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Send Invoice To:
Community Relations
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $2,206.72
SHIPPING INSTRUCTIONS "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
*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 �, Q
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 _1 4n.�cA,AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Nancy Heck
TITLE Director
CONTROL NO. 103604 CLERK-TREASURER