HomeMy WebLinkAbout55835 LAZER LINES LLC 0, 1,n„ INDIANA RETAIL TAX EXEMPT PAGE 1
City.
qy CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 55835
35-60000972
ONE CIVIC SQUARE
C.ARMEL,IN DIAILIA 46O 32_2 84 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
8/13/2021 08/16/21 26272 Rehabilitate the Monon Greenway from Main Street to 146th
Lazer Lines LLC Parks Maintenance
5307 Autumn Ln 1427 E. 116th Street
VENDOR Lafayette, IN 47909 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
4.500 each sealmaster liquid road $ 10,978.000 $49,401.00
1.000 each asphalt repair $4,062.000 $4,062.00
1.000 each crack seal $2,500.000 $2,500.00
1.000 each striping $ 950.000 $ 950.00
5.000 each stop bars and stop stencil $ 100.000 $ 500.00
GLAccount# 1030000-4460703
Send Invoice To:
$ 57,413.00
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 Michael Allen
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Parks& Natural Resources Director
CONTROLLER
DOCUMENT CONTROL NO. 55835 VIh::INIDOI 4:;4: IF Y