HomeMy WebLinkAbout110554 HYLANT GROUP
City of Carmel
EachSub Total
Department:Account:Fund:
1General Insurance$200,000.00Page 1 of 1$200,000.00$200,000.00
120543-475.00101General Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Dept of Administration
110554
FEDERAL EXCISE TAX EXEMPT
35-6000972
1 Civic Square
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
Carmel, IN 46032-
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PLEASE INVOICE IN DUPLICATE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTIONDEPARTMENTACCOUNTPROJECTPROJECT
ACCOUNTAMOUNT
$200,000.00
PAYMENT
12/13/202300352999
* A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
HYLANT GROUP General Administration
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
PO BOX 638720 1 Civic Square
*C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
TO
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
CINCINNATI, OH 45263--8720
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
James CriderJames Crider
TITLE
83273Director of AdministrationDirector of Administration
110554
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION