HomeMy WebLinkAboutSpecialized Land Services, Inc./ENG/$2,075/Buying Services - Parcel 10 - 106th and College RAB - ASACzTfshfzHsfdivlijobu4;1:qn-Nbz35-3133
DocuSign Envelope ID: 11CA898D-D269-4C41-BA6C-5B6F285E825B
6/1/2022
6/1/2022
6/1/2022
6/1/2022
Exhibit A
DocuSign Envelope ID: 11CA898D-D269-4C41-BA6C-5B6F285E825B
5/24/2022
SPECIALIZED LAND SERVICES INC
SUITE C
CARMEL, IN 46032 -
106565
630 N RANGELINE RD
City of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35-6000972
PURCHASE ORDER NUMBER
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR SHIP
TO
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
EXTENSION
20-ENG-02 - Buying Services - Parcel 10
City Engineering's Office
1 Civic Square
Carmel, IN 46032-
376319
UNITPRICEDESCRIPTIONUNITOFMEASUREQUANTITY
Page 1 of 1
Laurie Slick
66038
2200Department:0Fund:2020 Road Bond
44-628.71Account:
20-ENG-02 - Buying Services Parcel101 $2,075.00 $2,075.00Each
2,075.00SubTotal
2,075.00
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
SHIPPING INSTRUCTIONS
SHIP PREPAID.
C.O.D. SHIPMENT CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
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
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
CONTROL NO. 106565
ORDERED BY
TITLE
CONTROLLER
City Engineering's Office
1 Civic Square
Laurie Slick
Carmel, IN 46032-
Jeremy Kashman
Director
DocuSign Envelope ID: 11CA898D-D269-4C41-BA6C-5B6F285E825B