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204698 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 00350847 Page 1 of 1 ONE CIVIC SQUARE ALI -ABA COMM ON CONT PROF EDUCAT�Q CHECK AMOUNT: $1,014.00 CARMEL, INDIANA 46032 4025 CHESTNUT STREET PHILADELHIA PA 19104 CHECK NUMBER: 204698 CHECK DATE: 12/20/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4357004 26021 800280 1,014.00 REGISTRATION FEE ALL ABA Invoice No. 800280 i 4025 Chestnut Street I N O ICE Philadelphia, PA 19104 -3099 t V Telephone: (800) 253 -6397 Sold Douglas C. Haney Ship Douglas C. Haney To: City of Carmel, Indiana To: City of Carmel, Indiana 1 Civic Sq 1 Civic Sq Carmel, IN 46032 -2584 Carmel, IN 46032 -2584 USA USA Account No. Purchase Order No. Order Date Order Number Terms Invoice Date 181343 P.O. 26021 12/09/2011 623343 Net 30 days 12/09/2011 Qty Item Code Description Unit Price Extended i Shipped Price Eminent Domain and Land Valuation Litigation 01/26/2012 01/28/2012 San Diego, CA 1 CT0301FULL Full Registration 1,014.00 1,014.00 i Line Item fatal Freight Handling Other Tax ullatot�ll Anlallnt Received Amount Due 1,014.00 1,014.00 1,01/1.00 i PAGE Carm CE INDIANA RETAIL TAX RTTIFICATE NO. 003120155 02 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT,/ 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP 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 VENDOR SHIP TO CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Q� r t; j t Cn'/ V FLO e r D Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT aJ �f PAYMENT y 1�j 0/ el'eo /f A/P VOUCHER CANNOT BE APPROVED 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 AN UNOBLIGATED BALANCE IN SHIP REPAID, TFjS APPROPRh4TJ N SUFFICIENT TO PAY FOR THE ABOVE ORDER. 44 C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY f PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. j THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ti CLERK TREASURER DOCUMENT CONTROL NO- 26021 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.- WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR yuo Board Members PO# or INVOICE NO. ACCT /T'ITLE AMOUNT I hereby certify that the attached invoice(s), or n l Q OZ) bill(s) is (are) true and correct and that the o� materials or services itemized thereon for which charge is made were ordered and received except iL` llvci �S 20 titu re Title Cost distribution ledger classification if claim paid motor vehicle highway fund