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CERTIFICATEINDIAA NO.ETAI 003120155TAEXEMPT 002 0 PAGE 1
C itY 0 i N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT 54125
35-60000972
ONE crnc SQUARE
CARMEL,INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
2/12/2020 02/17/20 22683 373213 Amendment to AIA Document B101-2017 Design Services for
Clay Township
SmithGroup, Inc. Administration Office
201 Depot Street Second Floor 1411 E. 116th Street
VENDOR Ann Arbor, MI 48104 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
$ 1.000 each Fee for Architect's Basic Services for the Expanded Scope 245,000.000 $245,000.00
$ 1.000 each Potential Permitting 15,000.000 $ 15,000.00
$ 1.000 each Reimbursables NTE 15,000.000 $ 15,000.00
GLAccount# 1060000-4460708
Send Invoice To:
$275,000.00
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 Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54125 VIE 1NID 0 IR CO Y