HomeMy WebLinkAbout203148 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 00352011 Page 1 of 1
ONE CIVIC SQUARE RESERVE ACCOUNT
CARMEL, INDIANA 46032 PO BOX 223648 CHECK AMOUNT: $5,100.00
PITTSBURGH PA 15250 -2648
CHECK NUMBER: 203148
CHECK DATE: 10/25/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 4342100 37241700 5,100.00 37241700
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Pitn Bowes o
I rp 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 J
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Send with check to: Reserve Account, PO Box 223648, 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
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f� I(\ INDIANA RETAIL TAX EXEMPT PAGE
City ®,Jjr CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
0t�'4K j NL�V 7 flu) FEDERAL 5- EXC
0972 EXEMPT y nL/
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR �t� SHIP TO
CONFIRMATION BLANKET CONTR CT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
76, ue a, t W
e
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1207 o- PAYMENT �s� /l�0 •DD
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
•cam VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY /!/�J' ®�y�' A,/
SHIPPING LABELS. ��C/�f. 1 /l o ms /�J/�"
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THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 2
A.P.V. COPY -SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.__
ALLOWED 20
IN THE SUM OF
ON A COUNT OF APPROPRIATION FOR
PO# or Board Members
INVOICE NO, ACCT #/fITLE AMOUNT I hereby certify that the attached invoice(s), or
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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
e 20 2
ure
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund