HomeMy WebLinkAboutSpecialized Land Services, Inc./ENG/$18,675/Haverstick MU Path - Buying Services - ASACzTfshfzHsfdivlijobu2;35qn-Efd18-3133
DocuSign Envelope ID: 90B4CA35-810F-4B4C-8A71-145F6440AD8E
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12/21/2022
12/21/2022
12/21/2022
Exhibit A
DocuSign Envelope ID: 90B4CA35-810F-4B4C-8A71-145F6440AD8E
11/30/2022
SPECIALIZED LAND SERVICES INC
SUITE C
CARMEL, IN 46032 -
108027
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-06 - Haverstick Path - Buying Services
City Engineering's Office
1 Civic Square
Carmel, IN 46032-
376319
UNITPRICEDESCRIPTIONUNITOFMEASUREQUANTITY
Page 1 of 1
Laurie Slick
71894
2200Department:0Fund:2020 Road Bond
44-628.71Account:
20-ENG-06 - Haverstick Path - BuyingServices1 $18,675.00 $18,675.00Each
18,675.00SubTotal
18,675.00
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. 108027
ORDERED BY
TITLE
CONTROLLER
City Engineering's Office
1 Civic Square
Laurie Slick
Carmel, IN 46032-
Jeremy Kashman James Crider
Director Director of Administration
DocuSign Envelope ID: 90B4CA35-810F-4B4C-8A71-145F6440AD8E