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HomeMy WebLinkAboutSmock Fansler Corporation/Street/$22,600/Sophia Square Fireplace Removal - ASACzTfshfzHsfdivlijobu2;51qn-Tfq19-3133 DocuSign Envelope ID: 5642928D-5E46-45C0-98D6-83D681323032 9/21/2022 9/21/2022 9/21/2022 9/21/2022 Exhibit A DocuSign Envelope ID: 5642928D-5E46-45C0-98D6-83D681323032 Page 1 of 1INDIANARETAILTAXEXEMPT CERTIFICATE NO. 003120155 0020PURCHASE ORDER NUMBERCityofCarmel FEDERAL EXCISE TAXEXEMPT 106786 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES, A/PONECIVICSQUARE VOUCHER, DELIVERY MEMO, PACKING SLIPS, CARMEL, INDIANA 46032-2584 SHIPPING LABELS AND ANY CORRESPONDENCE FORM APPROVED BYSTATE BOARD OFACCOUNTS FOR CITY OFCARMEL - 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 9/6/202200350511 SMOCK FANSLER CORP Street Department VENDORSHIP2910WMINNESOTAST 3400 W. 131st Street TO Carmel, IN 46074- INDIANAPOLIS, IN 46241 - (317) 733-2001 PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 68760 QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION Department:Fund: 1206101General Fund Account: 43-509.00 1EachSophia Square Fireplace Removal$22,600.00$22,600.00 Sub Total 22,600.00 Send Invoice To: Street Department 3400 W. 131st Street Carmel, IN 46074- 317) 733-2001 PLEASE INVOICE INDUPLICATE DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT 22,600.00PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE ASHIPPINGINSTRUCTIONSPARTOFTHEVOUCHERANDEVERYINVOICEANDVOUCHERHASTHEPROPERSWORN 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 LABEL THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 ORDERED BYANDACTSAMENDATORYTHEREOFANDSUPPLEMENTTHERETO. LeeHigginbotham TITLECommissioner CONTROL NO. 106786 CONTROLLER DocuSign Envelope ID: 5642928D-5E46-45C0-98D6-83D681323032