HomeMy WebLinkAbout57111 MID STATE TRUCK EQUIPMENT INDIANA RETAIL TAX EXEMPT PAGE 1
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1,u ar CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 57111
35-60000972
ONE CIVIC SQUARE
CARMEL,INDIANA 4E0 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
8/25/2022 05/03/22 28054 201250 Kubota-Salt Spreader Parts and Plow
Mid State Truck Equipment Inc. Parks Maintenance
11020 Allisonville Rd 1427 E. 116th Street
VENDOR Fishers, IN 46038 SHIP Carmel, IN 46032
To
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each VBS14399-Tarp for Boss-VBX $289.130 $289.13
1.000 each MSC14275-Vibrator, 12vdc 2001b $ 149.600 $ 149.60
1.000 each BAR13204-Boss UTV cutting edge poly $203.670 $203.67
1.000 each BAL13104-Cuttingedge kit poly $203.670 $203.67
1.000 each MSC09601 -Control, handheld. smartouch 2 v blade $ 304.200 $ 304.20
GLAccount# 1125401-4350000
Send Invoice To:
$ 1,150.27
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. 57111 VII=::INIDO COPY