HomeMy WebLinkAbout102786 SJCA ENGINEERS & SURVEYORS
Page 1 of 1
INDIANA RETAIL TAX EXEMPT
PURCHASE ORDER NUMBER
CERTIFICATE NO. 003120155 002 0
City of Carmel
FEDERAL EXCISE TAX EXEMPT
102786
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
Project 19-02; Contract Date 05.01.19
4/9/2019370365
SJCA ENGINEERS & SURVEYORS City Engineering's Office
VENDORSHIP
9102 NORTH MERIDIAN ST, SUITE 200 1 Civic Square
TO
Carmel, IN 46032-
INDIANAPOLIS, IN 46260 - Kate Lustig
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
35269
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
220002010 Bond Fund
Account:
44-628.71
1EachASA 1 - Additional Bank Stabilization Scope Change$20,800.00$20,800.00
1EachASA 1a - Additional Permitting; Letting; Mitigation; Material $25,000.00$25,000.00
Revision
Each
1Replacement and Rehabilitation of Multiple Bridges in $233,380.00$233,380.00
Brookshire Golf Club
Sub Total
$279,180.00
Department:Fund:
2200250Storm Water
Account:
43-509.00
Each
1ASA 1b - Design Scope Change - Additional Funding $5,250.00$5,250.00
Causing Change in Bid Pkg
Sub Total
$5,250.00
Send Invoice To:
City Engineering's Office
Kate Lustig
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$284,430.00
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.
102786
CONTROLLER