188520 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 363231 Page 1 of 1
ONE CIVIC SQUARE SIGN A RAMA CHECK AMOUNT: $208.00
CARMEL, INDIANA 46032 598 WEST CARMEL DRIVE #B
«o CARMEL IN 46032 CHECK NUMBER: 188520
CHECK DATE: 8/3/2010
DEPARTMENT -ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239030 18060 208.00 TRAFFIC SIGNS
f
V.
Sign -A -Rama Carmel
_1
598 W. Carmel Dr. Suite B WHERE THE WORLD GOES FOR SIGNS
Carmel, IN, 46032- USA
Phone: (317) -575 -1805 Fax: (317)- 575 -1825 INVOICE 18060
www.signaramacarmel.com
safes @signaramacarmel.com Invoice Date 7/16/2010
SOLD TO SHIP TO
CARMEL STREET DEPARTMENT CARMEL STREET DEPARTMENT
3400 W 131 ST STREET 3400 W 131ST STREET
WESTFIELD, IN 46074- USA WESTFIELD, IN 46074- USA
Phone (317) 733 -2001 Ext Fax: (317) 733 -2005
Job Box
E -mail: BCALLAHAN@CARMEL. IN. GOV
Quote# Quote Date Completed Cust Id I PO Nu e m ber PO Dat Terms Code 1 Sales Rep Page
I
00875 7/1312610 CARMEL5006 DUE UPON O RD ER 1 H S 1 o 1
Qty Ordered Description Unit Price Extended Price
4 FARMERS MARKET STREET SIGNS "SLOW'
ALUMINUM PANEL (.080)
HEIGHT: 0 Ft 18 In LENGTH: 0 Ft 24 In SIDES: 1
A6 BLACK, A6 YELLOW
$52.00 $208.00
I- Prices valid for 30 days. Payment terms and conditions apply Unless otherwise noted 3. Please understand that payment is expected as described in the terms. Late Taxable: $208.00
payment terms are 50% deposit required to begin production on this order. In addition, an payments will be charged a $35 late payment fee plus interest charges (currently NonTaX $0. 00
approved layout proof is required before production begins. .066% per day) and collection costs (indluding adorney fees and collection agency
2. Signs are warranted for a period of 1 year against workmanship defects- Sign components fees) on any outstanding balances from the invoice date. Sign -A -Rama maintains all esTax: $14.56
may have longer warranties. Please ask your sales representative for details. Your purchase rights to produced products (including removal of any signs) until the invoice and any
order or terms do not superceed this agreement unless specifically noted on our invoice. Site applicable charges are paid in full. Frefgh $0.00
ditions,
conditions related to structure, previous sign con unusual conditions, or components not 4. Other reasonable terms and conditions may apply based upon the type or wo k
provided by us can not be covered by our warranty. requested. Vie have specific conditions related to copyright protection and installation Isi $0.00
standards. By signing this agreement you are agreeing to those to s and condibi erTOtal: $222.56
even though they are not listed here. A copy of our complete terms con iu i,vy
be gladly provided upon request. Payments: $0.00
Visit us on the web
Net Due: $222.56
www.signaramacarmel.com
Total Due Amount $222.56
Form ST -105 Indiana Department of Revenue
State Form 49065 RA/ 8 05 General Sales Tax Exemption Certificate
Indiana registered retail merchants and businesses located outside Indiana may use this certificate. The claimed exemption must be allowed by Indiana
code. Exemption statutes of other states are not valid for purchases from Indiana vendors. This exemption certificate can not be issued for the
purchase of Utilities Vehicles Watercraft, or Aircraft. Purchaser must be registered with the Department of Revenue or the appropriate taxing
authority of the purchaser's state of residence.
Sales tax must be charged unless all information in each section is fully completed by the purchaser. Purchasers not able to provide all required
information must pay the tax and may file a claim for refund (Form GA -1l OL) directly with the Department of Revenue.
Nance of Purchaser CITY OF CARMEL
Business Address ONE CIVIC SQUARE City CARMEL State IN Zi 46032
S C_- Purchaser must provide minimum of one ID number below.*
t Provide your Indiana Registered Retail Merchant's Certificate
QY TID and LOC Number as shown on your Certificate 0031201550 020
TID# (10 digits) LOC# 3 digits)
TU`
rat If not registered with the Indiana DOR, provide your State Tax
ID Number from another State.._
*See instructions on the reverse side if you do not have either number. State ID# State of Issue
g,=t Is this a 0 blanket purchase exemption request or a E] single purchase exemption request? (check one)
Description of items to be purchased.
MI
Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain)
Sales to a retailer, wholesaler, or manufacturer for resale only.
Sale of manufacturing machinery, and equipment to be used directly in direct
R S Y. y' p roduction-
p
icy
3? ei F?
Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin #10.
(May not be used for personal hotel rooms and meals.)
r
Sales of tangible personal property predominately used (greater then 50 percent) in providing public transportation provide IJSDOT
e
A person or corporation who is hauling under someone else's motor carrier authority, or has a contract as a school bus operator, must
?off provide their SS# or FID# in lieu of a State 1D# in Section #1. USDOT#
Sales to persons, occupationally engaged as farmers, to be used directly in production of agricultural products for sale.
�i
Note: A farmer not possessing a State Business License# may enter a FID# or a SS# in lieu of a State Ill# in Section #1.
.rr
Sales to a contractor for exempt projects (such as public schools, government, or nonprofits).
❑Sales to Indiana Governmental Units (agencies, cities, lawns, municipalities, public schools, and state universities).
Sales to the United States Federal Government show agency name.
nM ]Vote: A U.S. Government agency should enter its Federal Identification Number (FID in Section #1 in lieu of a State ID
a
Other explain,
s i I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for an exempt
b purpose pursuant to the State Gross Retail Sales Tax Act. Indiana Code 6 -2.5, and the item purchased is not a utility, vehicle, watercraft, or aircraft.
�U.
o I confirm my understanding that misuse.. either negligent or entional), and /or fraudulent use of this certificate may subject both me personally
and /or the business entity I represent e imposition
.1
ter and civil and /or criminal penalties.
rA� Signature of Purchaser Date
0 Printed Name DIANA L CORDRAY Title CLERK- TREAURER
The Indiana Department of Revenue may request verification o registration in another state if you are an out -of -state purchaser.
Seller must keep this certificate on rile to support exempt sales.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Sign *A *Rama
IN SUM OF
598 W. Carmel Drive Suite B
I
Carmel, IN 46032
$208.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE I AMOUNT Board Member
2201 18060 42- 390.30 $208.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
l� Tuesday Jul 2 0
r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 261 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/16/10 18060 $208.00
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer