HomeMy WebLinkAbout36211 Peerless Midwest L INDIANA RETAIL TAX EXEMPT PAGE
Tity of L arm.e I LTFCAiil2o155 002 0
PLIRc!IASE ORDER.NUMEER
FEDERAL EXCISE TAX EXEMPT 36211
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES.A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERS' MEMO. PACKING SUPS.
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMIEI. - 1997
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PURCHASE ORDER DKIE DATE REQUIRED REQUISITION NO. VENDOR NO DESCRIPTION
9/26/13 I N/A Flowing Well Repairs
L..
Peerless Midwest AO
1-110—/ Sun Park 7)i-iv e SHIP RIECFINTED,
VENDOR
Wes-t.field lizto")4. TO SEP 26 2013
BY:
CONr•trwARCN Si ANKET CONTRACT; PAYMENT TERMS FREIGHT
CUANTITY UNIT 09 MLASUREj DES'CRIP'JON UNIT PRICE EXTENSION
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1 EA Color Video Inspection $1,000.00 $1,000.00
1 EA Material required for Repairs $2,500.00 $2,500.00
1 EA Labor for Repairs $4,800.00 $4,800.00
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Send Invoice To
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$8,300.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT i PROJECT ACCOUNT AMOUNT
1125-4-07-4350100-Building Repairs & Maintenance PAYMENT
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NP VOUCHER CANNOT RF.APPROViD FUR PAYMENT UNLESS THE PO
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTAci Ica
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS iN MOB:A(147ED BALANCE IN
SHIP REPAID THIS APPROPRIATION SUFFICIENT P PAY FOR HE ABOVE ORDER.
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•C.O.D SHIPMENTS C.ANNOT BE ACCEPTED Michael Klitzing - DK iChtLiy
ORDERED BY nir),ADCk C?/2U.
• PURCHASE ORDER NUMbEI-1 MUS1 APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE.WITH CHAPTER 99.ACTS 1945 TITLE -r N1(.1,//3
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
36211 CLERK-TREASURER
DOCUMENT CONTROL NO. vE1,12s,0f1 COPY