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193210 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 00352011 Page 1 of 1 0 I ONE CIVIC SQUARE RESERVE ACCOUNT CHECK AMOUNT: $8,700.00 CARMEL, INDIANA 46032 PO BOX 223648 PITTSBURGH PA 15250 -2648 CHECK NUMBER: 193210 CHECK DATE: 12/22/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 209 4342100 37241700 4,700.00 37241700 209 R4342100 21194 37241700 4,000.00 POSTAGE L' Pitney Bowes Use this coupon for postage deposits. Make checks payable to Reserve Account. Reserve Account No.: 37241700 Reserve Account City of Carmel Mayors Office PO Box 223648 Pittsburgh, PA 15250 -2648 ®O D 0 Send with check to: Reserve Account, PO Box 223646, Pittsburgh, PA 15250 -2648 Mail overnight checks to: Reserve Account, Attn: Box 223648, 500 Ross Street, Suite 154 -0460, Pittsburgh, PA 15262 -0001 The Pitney Bowes Bank, Inc. Member FDIC 372417000 C o INDIANA RETAIL TAX EXEMPT PAGE it of C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER —f 7 j j FEDERAL EXCISE TAX EXEMPT J'�F4•. G'I� !L- 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. 'URCHASE ORDER DATE DATE REOUIRED REQUISITION IN VENDOR NO. DESCRIPTION �r VENDOR �l�t�i� -L��/t TOHIP CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION r 12 0 tea.." ✓'x."r° Send Invoice To: o �w' PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1/'3 s� 77 a/"o PAYMENT 0 D a A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE AND NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY, THAT THERE IS AN UNOBLIGATED BALANCE IN NU SHIP REPAID. THIS _APPROPRIATION OPRIATION SuF ICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. t THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. f CLERK TREASURER DOCUMENT CONTROL No-27137 A.P.V. COPY SIGN AND RETURN TO C LERK'S OFF VOUCHER NO._ WARRANT NO. ALLOWED 20 4 W U t4 i IN THE SUM OF 700 oa O CCOUNT OF APPROPRIATION FOR -4` oo Board Members I'O# or INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoices or /7 bill(s) is (are) true and correct and that the f -aid materials or services itemized thereon for which charge is made were ordered and received nature Title Cost distribution ledger classification if claim paid motor vehicle highway fund