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City of
Carmel CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 58574
35-60000972
ONE CIVIC SQUARE
VOUC ERB DELIVERY AMEMO,PACKING SLIPS,
P
CARMEL,INDIANA 46032-2E84 THIS NUMER MUST
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
8/17/2023 08/22/23 32499 371208 Employee Service Recognition
PinMart Administration Office
PAID THROUGH UFB-VISA 1411 E. 116th Street
VENDOR Elan Financial Services SHIP Carmel, IN 46032
TO
PO BOX 790408
St Louis, MO 63179 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
10.000 each Fifteen Year Service Pin#TS324 $2.990 $29.90
10.000 each Ten Year Service Pin#TS211 $2.990 $29.90
20.000 each Five Year Service Pin#TS210 $2.990 $59.80
GLAccount#8530000-5023990
Send Invoice To:
$ 119.60
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT [ PROJECT PROJECT ACCOUNT
UNT 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 Claudine Sutton )1 Z•23
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Human Resource Director
CONTROLLER
DOCUMENT CONTROL NO. XX-13349 VENDOR COPY ��