106074 DLZ INDIANA LLC - REVISED
Page 1 of 1
INDIANA RETAIL TAX EXEMPT
PURCHASE ORDER NUMBER
CERTIFICATE NO. 003120155 002 0
City of Carmel
FEDERAL EXCISE TAX EXEMPT
106074
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
Addendum Construction Observation - 16-ENG-97, 16-ENG-55
12/15/2021061515
and 16-ENG-109
DLZ INDIANA, LLC. City Engineering's Office
VENDORSHIP
138 N DELAWARE ST 1 Civic Square
TO
Carmel, IN 46032-
INDIANAPOLIS, IN 46204 - Laurie Slick
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
62089
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
2200202Local Road & Street Fund
Account:
43-509.00
1EachAddendum Construction Observation - 16-ENG-97, 16-ENG-$17,610.32$17,610.32
55 and 16-ENG-109
Sub Total
$17,610.32
Send Invoice To:
City Engineering's Office
Laurie Slick
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$17,610.32
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.
106074
CONTROLLER