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CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
a 35- 60000972
ONE CIVIC SQUARE THIS NUMBER M!$fi xtm +EAR ON INVOICES. A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL -.1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/14/2011
VENDOR T. M. T. Inc" SHIP Street Department
TO
3400 W. 131st Street
1719 W. 161st Street Carmel, IN 46074
CONFIRMATION BLANKEW3$tfi$IQ TI V 46074 PAYMENT TERMS (317) 733 -2001 FREIGHT
Suzy DUBo s
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 0043- 504.00 Pe(
1 E
4 +.p- entg $0,720.00 $0,720.00
1 Each plant replacements $10,650.00 $10,650.00
Sub Total:
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co
silk Send Invoice To: f
S 0 M
Street Department
3400 W: 131 st Street
Carmel, IN 46074- PLEASE INVOICE IN DUPLICATE 1 10, (p SC, 00
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 'AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESSli
Carmel Street Department NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOIC
VOUCHER HAS THE PROP ,ER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATTHERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID. THIS APPROPRIATIOWSU. PAY FOR THE ABOVE ORDER
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. S
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING U
O r-,
THIS ORDER R ISSUED INCOMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
d
CLERK TREASURER
OCUMENT CONTROL NO. 27379 OFFICE COPY