HomeMy WebLinkAbout57167 AYERS BACKFLOW CHECK SERVICE 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 57167
35-60000972
ONE CIVIC SQUARE
C.ARMEL,INDIANA46032_2 E,4 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
9/15/2022 07/16/22 28813 359 344 Service-Parks 2022 Annual Backflow Testing
Ayers Backflow Check Ser Parks Maintenance
20 Bennett Rd 1427 E. 116th Street
VENDOR Carmel, IN 46032 SHIP Carmel, IN 46032
To
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
9.000 each Backflow Testing at AO, West Park, Meadowlark, Carey Grove, $45.000 $405.00
Inlow Founders, River Heritage, Flowing Well
1.000 each Backflow Testing at West Park 4" $ 50.000 $ 50.00
GLAccount# 1125401-4350100
9.000 each Backflow Testing at South Trail Head, North Trail Head, Monon $45.000 $405.00
BLVD shuffle board, BLVD splash pad, BLVD elm st., BLVD
Elm St., BLVD Luxury Cakes, BLVD NE corner 2nd,
Carmichael Public Restroom
1.000 each Carmel Water Utility Fee $ 107.000 $ 107.00
1.000 each Backflow Testing and Parts- Perelman Pavilion $ 113.000 $ 113.00
GLAccount# 1125423-4350100
Send Invoice To:
$ 1,080.00
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 Cody McCollum
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Parks Coordinator
CONTROLLER
DOCUMENT CONTROL NO. 57167 4:;4: IF Y