HomeMy WebLinkAbout57838 UNITED CONSTRUCTION SERVICES LLC INDIANA RETAIL TAX EXEMPT PAGE 1
CitY
� CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 57838
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
3/24/2023 03/27/23 30962 375267 West Park Shelters Project
United Construction Services, LLC Administration Office
347 S Broadway St 1411 E. 116th Street
VENDOR Pendleton, IN 46064 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
$ 1.000 each Site work and installation of shelters 360,071.000 $ 360,071.00
GLAccount# 1060000-4460708
Send Invoice To:
$ 360,071.00
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 Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Purchasing Administrator
CONTROLLER
DOCUMENT CONTROL NO. 57838 VENDOR COPY