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INDIANA RETAIL TAX EXEMPT
PURCHASE ORDER NUMBER
CERTIFICATE NO. 003120155 002 0
City of Carmel
FEDERAL EXCISE TAX EXEMPT
105319
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
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
ASA 1 - 10-10; Illinois Street Extension Mitigation at Brookshire
6/14/202100351256
Golf Course
UNITED CONSULTING City Engineering's Office
VENDORSHIP
8440 ALLISON POINTE BLVD 1 Civic Square
TO
SUITE 200 Carmel, IN 46032-
INDIANAPOLIS, IN 46250 - Laurie Slick
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
57073
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
2200250Storm Water
Account:
43-509.00
1EachASA 1 - 10-10; Illinois Street Extension Mitigation at $32,900.00$32,900.00
Brookshire Golf Course
Sub Total
$32,900.00
Send Invoice To:
City Engineering's Office
Laurie Slick
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$32,900.00
PAYMENT
* A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
Jeremy Kashman
TITLE
Director
CONTROL NO.
105319
CONTROLLER