HomeMy WebLinkAbout55768 MATTINGLY CONCRETE INC - REVISED INDIATAX EXEMPT PAGE 1
City o,� Cannel ry CERTIFICATE NO.003120155 002 0 TAX EXEMPT PURCHASE ORDER NUMBER
FEDERAL EXCISE 55768
35-60000972
ONE CIVIC SQUARE
CARMEL,INDIAt 032 2584 THIS NUMBER MUST APPEAR ON INVOICES,/VP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 __. ___..._.._......._... ........................................W..............
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
8/2/2021 07/11/21 25943 00351005 Greyhound/Hagen Burke Trail Bridge Transition Concrete
Repairs
Mattingly Concrete Inc. Parks Maintenance
15936 Joliet Rd 1427 E. 116th Street Neil
VENDOR Westfield, IN 46074 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS
_....,.. ....., ..m,,,,, ,,,,,,,,,, ,,,,_.............. ...... FREIGHT
QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION
1.000 each Bridge transition repairs at Hagan Burke bridge $5,477.000 $5,477.00
1.000 each Bridge transition repairs at Greyhound bridge $5,477.000 $5,477.00
GLAccount#
Send Invoice To:
$ 10,954.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT
• AIP 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 J �'y�i,� 1 r_IR I / )'I(txJ�
• 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. 55768 VENDOR COPY