HomeMy WebLinkAbout114248 LOR RANGELINE LLC - REVISED
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INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
City of Carmel
FEDERAL EXCISE TAX EXEMPT
114248
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
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
Reimbursement - 111 S. Range Line Road
12/19/2024377582
LOR RANGELINE LLC City Engineering's Office
VENDORSHIP
6350 RUCKER RD #101 1 Civic Square
TO
Carmel, IN 46032-
INDIANAPOLIS, IN 46220 - Laurie Slick
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
95158
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
2200202Local Road & Street Fund
Account:
43-509.00
1EachReimbursement - 111 S. Range Line Road - Additional $14,499.13$14,499.13
Request
Each
1Reimbursement - 111 S. Range Line Road - Additional $177,660.10$177,660.10
Request
Sub Total
$192,159.23
Send Invoice To:
City Engineering's Office
Laurie Slick
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$192,159.23
PAYMENT
* 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
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.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
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
Bradley PeaseZac Jackson
TITLEDirectorCFO
CONTROL NO.
114248