HomeMy WebLinkAbout55194 BLAKLEY CORPORATION INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
x
PURCHASE ORDER NUMBER
.. " FEDERAL EXCISE TAX EXEMPT
55194
35-60000972
ONE CIVIC SOUARE
(CARMEL, IN 11.A1,1A„„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
New Vendor
2/24/2021 02/14/21 24843 W-9 attached City Center Tunnel Repairs
Blakley Corporation Parks Maintenance
8060 E 88th Street 1427 E. 116th Street ATTN: Courtney
VENDOR Indianapolis, IN 46256 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each mobilization &demobilization $ 1,383.140 $ 1,383.14
1.000 each epoxy injection &crack preparation $3,380.580 $ 3,380.58
1.000 each patching concrete structures $5,870.950 $ 5,870.95
1.000 each caulk expansion joints $ 11,371.890 $ 11,371.89
1.000 each patch ceiling holes $2,074.710 $2,074.71
GLAccount# 1030000-4460703
Send Invoice To:
$24,081.27
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 Michael Allen
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 55194 V IF;;;III D Ih I,,,