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HomeMy WebLinkAbout31259 Dallman COntractors o1JXXMM F-WMiwaSTIS 0 INDIANA'RETAIL TAX EXEMPT PAGE City\�/ ®f Carmel a�+ e I, pp CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 31259 • 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SUPS, 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 9/19/2013 Dallman Contractors, LLC Street Department VENDOR SHIP 3400 W. 131st Street TO 5808 W. 74th Street Carmel, IN 46074 Indianapolis, IN 46278 (317) 733-2001 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION Account 0043-509.00 1 Each Keystone Bridges Concrete Maintenance $74,357.00 $74,357.00 Sub Total: $74,357.00 Of, _o_cAr©4Hr- 4p+% 0 0 , .4 *ill, .. ‘..<9 ..:. •-• --4 Send Invoice To: %-J""-' °" r�- Ai l . Street Department 3400 W. 131st Street Carmel, IN 46074- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Street Department PAYMENT $74,357.00 • APP 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. THIS APPRO'•AT ON-SUFFICIENT/TOOPAYFOR THE ABOVE ORDER. • C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY i • �/� • • PURCHASE ORDER NUMBER MUST APPEAR ON ALL 1 SHIPPING LABELU. t/ 1 � g •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE pjyhl �-re AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. q C c� CLERK-TREASURER DOCUMENT CONTROL NO. 31259 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE