HomeMy WebLinkAbout58544 AYERS BACKFLOW CHECK SERVICE tyr
1,u .,ar11, 1
INDIANA RETAIL TAX EXEMPT PAGE 1
qy CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 58544
35-60000972
ONE CIVIC SQUARE
CARMEL,IN DIA.NA 4611S2-2 n4i, 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
8/14/2023 07/29/23 32272 359344 Service-Parks 2023 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 address PNR office,West Park, $45.000 $405.00
Meadowlark, Carey Grove, Inlow (2), Founders, River Heritage,
Flowing Well
1.000 each Backflow Testing at West Park 4" $ 55.000 $ 55.00
GLAccount# 1125401-4350100
11.000 each Backflow Testing at South Trail Head, North Trail Head, 443 $45.000 $495.00
Monon BIVD, 209 Monon BLVD, 581 Monon BLVD,417
Monon BLVD, 194 W. Elm, Monon Green BLVD, 239 Monon
BLVD,Carmichael Public Restroom, Rotary
1.000 each 194 W Elm Repair Labor $ 60.000 $ 60.00
GLAccount# 1125423-4350100
Send Invoice To:
$ 1,015.00
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.OD 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 Operations Manager-Custodial
CONTROLLER
DOCUMENT CONTROL NO. 58544 Vlliliii1NID IF C II::aY