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CERTIFICATE NO.003120155 002 0
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PURCHASE ORDER NUMBER
II.. " FEDERAL EXCISE TAX EXEMPT
54798
35-60000972
ONE CIVIC SQUARE
(CARMEL, INal.11IIA„N „„ O 32-2 5,8,4 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
9/2/2020 09/05/20 23996 353483 Midtown Turf Repair 2020
Mr. B's Lawn Maintenance Inc. Parks Maintenance
5225 East 225th Street 1427 E. 116th Street ATTN: Courtney
VENDOR Noblesville, IN 46062 SOHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Over seed &straw $336.000 $ 336.00
1.000 each Aeration/Core $ 180.000 $ 180.00
1.000 each Labor $268.000 $268.00
GLAccount# 1125422-4350400
Send Invoice To:
$ 784.00
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 Andrew Burnett
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54798 II,,,;;;III DOR COPY