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CERTIFICATE NO.003120155 002 0
City o F N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT 57536
35-60000972
ONE CIVIC SQUARE
C.ARMEL,IN DIAILIA 46O 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
1/10/2023 01/14/23 30290 178002 Maintenance Day 12023 Culture/Employee Engagement
Supplies
Kroger MCC- East
P.O. Box 644467 1235 Central Park Drive East
VENDOR Pittsburgh, PA 15264-4467 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Snacks $ 30.000 $ 30.00
GLAccount#8530000-5023990
Send Invoice To:
$ 30.00
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 Jylian Riches
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Marketing &Communications Director
CONTROLLER
DOCUMENT CONTROL NO. 57536 VEEN IDOIR 4:;4: IF Y