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1 11 1 CERTIFICCATE NO. O. 003120155 155 002 0
PURCHASE ORDER NUMBER
it FEDERAL EXCISE TAX EXEMPT
F
f 35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUSbAPf f ON INVOICES, AIP
CARMEL, INDIANA 46032 -2584 VOUCHER, DERV 'l10 PACKING SLIPS.
1 SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED, BY STATE. BOARD.OF ACCOUNTS FOR. CITY.OF. CARMEL —1997
PURCHASE ORDER DATE III DATE'REDUIREDPOi D::: ;RECE 7SON'NO VENDOR :NO. invoices DESCRIPTION
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42/20/2011 r
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VENDOR 1 Signal Construction TOHIP Street Department.
3400 W. 131st Street
x 5639 W. US 40 Carmel, IN 46074
CON FIRMATION BLANKET COONTR fell, IN 46140 PAYMENT TERMS (317)733- 203, REIGHT
GI QUANTITY it UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION
Account 0043-500.60
E q o� �1 CL tta I5 Oc,n, co
Sub Total:
l 6
f�f f
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Ag
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4. Air, c,
3- 7 I
Send I nvoice To:
Street Department
3400 W.13tst Street PLEASE INVOICE IN DUPLICATE 166 OW. O 0
DEPARTMENY`TIUroI, IN 4G074- ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
MP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
Carmel Street Department VOUCHER HAS THE PR0 ER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY TH f H RE ISAN UNOBLIGATED BALANC
SHIPPING INSTRUCTIONS F IN
I IN
THIS APPROPRIATI F IGENI TO PAY FOR THE ABO ORDER.
SHIP REPAID.
SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 4.•
C.O.D. C.
•PURCHASE NUMBER MUST APPEAR ON ALL 1 SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 6 2 5 9 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY