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INDIANA RETAIL TAX EXEMPT
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CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
104826
FEDERAL EXCISE TAX EXEMPT
35-6000972
ONE CIVIC SQUARE
:0195;4*-84;9:)77-)86515<61+-9#)%7
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CARMEL, INDIANA 46032-2584
9017715/3)*-39)5,)5>+688-9765,-5+-
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12/16/202000352999
HYLANT GROUP General Administration
VENDORPO BOX 638720 SHIP 1 Civic Square
TO
Carmel, IN 46032-
CINCINNATI, OH 45263--8720
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
52558
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
1205101General Fund
Account:43-475.00
Each
1General Insurance$194,365.00$194,365.00
Sub Total$194,365.00
Send Invoice To:
Dept of Administration
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$194,365.00
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ORDERED BY
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James Crider
TITLE
Director of Administration
104826
'10531.01#
CLERK-TREASURER