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CERTIFICATE NO.003120155 002 0
CitY o i Nei PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT
55875
35-60000972
ONE CIVIC SQUARE
CARMEL,INDIANA 4E0 32-2584 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
9/2/2021 09/05/21 26406 184000 Central Park Trail Head Restroom Fixture Replacements
Lee Supply Corp Parks Maintenance
P O Box 681430 1427 E. 116th Street
VENDOR Indianapolis, IN 46268 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
2.000 each Zurn PEMS6000-HYM-IS Side-Mounted Solenoid Actuator $ 140.723 $281.45
1.000 each Shipping $ 30.000 $ 30.00
GLAccount# 1125404-4237000
Send Invoice To:
$ 311.45
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 AND SUPPLEMENT THERETO. TITLE Park Maintenance Foreman
CONTROLLER
DOCUMENT CONTROL NO. 55875 VENDOR COIPY