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CERTIFICATE NO.003120155 002 0
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PURCHASE ORDER NUMBER
.. " FEDERAL EXCISE TAX EXEMPT
55064
35-60000972
ONE CIVIC SOUARE
(CARMEL, INaN.11I „I,1 A„„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
1/5/2021 01/10/21 24606 .1351893 Lagoon Aerator Parts
Aquatic Control Parks Maintenance
P.O. Box 1002 1427 E. 116th Street ATTN: Courtney
VENDOR Seymour, IN 47274 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
2.000 each LLGPSD37815A-capacitor for 3/4hp rotary vane compressor $68.400 $ 136.80
16.000 each LLG390 -Ilg ac393 vane filter element $ 10.490 $ 167.84
1.000 each Shipping $ 14.750 $ 14.75
GLAccount# 1125404-4237000
Send Invoice To:
$ 319.39
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 Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 55064 V IF III D Ih I,,,