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INDIANA RETAIL TAX EXEMPT
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CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
104790
FEDERAL EXCISE TAX EXEMPT
35-6000972
ONE CIVIC SQUARE
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CARMEL, INDIANA 46032-2584
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FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
ASA-13 On-Call Engineering and Inspection Services
12/10/2020068025
CROSSROAD ENGINEERS, PC City Engineering's Office
VENDOR3417 S SHERMAN DR SHIP 1 Civic Square
TO
Carmel, IN 46032-
BEECH GROVE, IN 46107 - Laurie Slick
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
52275
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
2200202Local Road & Street Fund
Account:
43-509.00
1EachASA-13 On-Call Engineering and Inspection Services$50,000.00$50,000.00
Sub Total$50,000.00
Send Invoice To:
City Engineering's Office
Laurie Slick
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$50,000.00
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Jeremy Kashman
TITLEDirector
104790
'10531.01#
CLERK-TREASURER