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HomeMy WebLinkAboutClark Dietz Inc./ENG/$142,121/20-ENG-06 Multi-Use Path along Haverstick from 96th to 99th St - Construction Inspection - ASABy Sergey Grechukhin at 4:30 pm, Sep 27, 2023 DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07 10/4/2023 10/4/2023 10/4/2023 10/4/2023 Exhibit A DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07 DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07 DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07 DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07 DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07 Ca31rmeCityCarmeINDIANA RETAIL TAX EXEMPT CERTIFICATE NO. 003120155 002 0 Page 1 Of 1 PURCHASE ORDER NUMBER J o\ J/ 11 ofEXCISE TAX EXEMPT 110085 THIS NUMBER MUSTAPPEARON INVOICES, AP ONECIVICSQUARE35.6000972 CARMEL, INDIANA 46032-2584 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 9/ 22/2023 060650 Professional Services Agreement dated 3N5I23 CLARK DIETZ, INC City Engineering's Office VENDOR 125 W CHURCH STREET SHIP 1 Civic Square TO Carmel, IN 46032- CHAMPAIGN, IL 61820 - Laurie Slick PURCHASED BLANKET CONTRACT PAYMENT TERMS FREIGHT 80957 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 2200 Fund: 0 2022 Bond Account: 44-628.71 1 Each 20-ENG-06 - Haverstick Rd Path from 96th to 99th Street - Construction Inspection Send Invoice To: 142, 121.00 Sub Total 142, 121.00 142, 121.00 Jill Newport CrossRoad Engineers, PC 115 N. 171h Avenue Beech Grove, IN 46107 inewoort(& crossroaden0ineers.com PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT $ 142,121.00 SHIPPING INSTRUCTIONS A' P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THEP O NUMBERISMADEA PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN SHIPPREPAID AFFIDAVIT ATTACHED I HEREBY CERTIFY THAT THERE ISAN UNOBLIGATED BALANCE IN C. 0 D SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY Jeremy Kashman Director James Crider Director of Administration CONTROL NO. 110085 TITLE CONTROLLER DocuSign Envelope ID: 1FAB5F44-D299-4448-9FD9-EA549FFF4D07