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INDIANA RETAIL TAX EXEMPT
1� or ^'m ` a rnieit' '',eERTIFIcIATE NO 003120155 002 0
o•^L `v PURCHASE ORDER NUMBER
•
• ,.. FEDERAL EXCISE TAX EXEMPT 26321
i 35-60000972 •
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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
12/18/2012
Smock Fansler Corporation Street Department
VENDOR SHIP 3400 W. 131st Street
TO
2910 W. Minnesota Street Carmel, IN 46074
Indianapolis, IN 46241-4541 (317) 733-2001
CONFIRMATION J§13,e&ONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
. Account 0043-504.00
1 .Each -urrplacement $32,575.00 $32,575.00
61 ULI `A I&At-, } qoucck h p1aLLA Sub Total: $32,575.00
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Send Invoice To:'.
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Street Department YV - !Ll-tJLG
3400 W. 131st Street
Carmel, IN 46074-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT. ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Street Department PAYMENT $32,575.00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAi THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY TIFY AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPR- 1ATI SUFFICIENT O pAY FOR THE ABOVE ORDER.
•SHIP REPAID. ��/ 1
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 26321 OFFICE COPY