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C ity CarmaL o CERTIFICATE NO. 003120155 002 0
�1J PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 28948
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
8 -31 -2011 M000557 Buildling repair at AO
VENDOR Passwater Construction T i J
17 ya SA L eEL L.
CA RC E TO O IP �o, I b 2011
WEST F E-Lb )N1 4 (DO(02 r
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
13 hrs Labor 65.00 845.00
Supplies /materials 200.00 200.00
1. Fill crack in brick with foam or silicone filler
2. Repair outer most cracks in dry wall
3. Cover drywall belaw-windows::iwth 1/4" oak veneer
4. Fill gaps in win6o tiseal
5. Paint/stain f,
TOTAL
I 1,045.00
R.:''.. 1 i' V' 1
1:..- 1•� 3 il f j 1.
1. I t.
4 ;p:, mot I .1
r 1,
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
3 5.01 00 PAYMENT
1125 -4 -02 Building repairs maintenance A/P VOUCHER CANNOT BEAPPROV :D FOR PAYMENT UNLESS THE P.O.
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 IN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS A' IATION SUFFICIENT '0 PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY C Sch .gel/R. S eising /M.Westermeier
PURCHASE ORDER NUMBER MUST APPEAR ON All
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITL N
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 111 I
28948 CLERK TREASURER
DOCUMENT CONTROL NO. VENDOR COPY