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INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
x
PURCHASE ORDER NUMBER
II
.. " FEDERAL EXCISE TAX EXEMPT
55244
35-60000972
DUE UWIU SQUARE
CARMEL,, INaNIl1 IUD „„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
3/19/2021 03/23/21 25030 361174 Utility Bill Park Construction Advertising Insert-March 2021
Worrell Corporation MCC- East
305 S. Post Road 1235 Central Park Drive East
VENDOR Indianapolis, IN 46219 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Utility Bill Insert to promote upcoming park construction $ 764.340 $ 764.34
projects (FYI -City Engineering paid for other half of total
invoice)
GLAccount# 1125200-4345000
Send Invoice To:
$ 764.34
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 Lindsay Labas
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 55244 Il,,,;;;III DOR COPY