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INDIANA RETAIL TAX EXEMPT PAGE 1
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CERTIFICATE NO.003120155 002 0
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PURCHASE ORDER NUMBER
.. " FEDERAL EXCISE TAX EXEMPT
54825
35-60000972
ONE CIVIC SOUARE
(CARMEL, IN 114,1,1A„„46032-25,8,4 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
9/10/2020 09/07/20 24041 369349 Trail Restroom Winterizing Valve-Outdoor Pump House
Ellis Mechanical, Inc. Parks Maintenance
2929 Bluff Road 1427 E. 116th Street ATTN: Courtney
VENDOR Indianapolis, IN 46225 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Materials for Pump Room Domestic Water Line $ 1,568.000 $ 1,568.00
1.000 each Insulation $550.000 $ 550.00
1.000 each Labor to Install $480.000 $480.00
GLAccount# 1125404-4350100
Send Invoice To:
$2,598.00
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 Courtney Weintraut
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54825 V IF;;;III D Ih I,,,