31681 HHPA Technology City ®f Carmel — INDIANA RETAIL 0312 155 00 PAGE
//111111 CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL'EXCISE TAX EXEMPT
35.60000972_ ; y, 31�1
ONE CIVIC SQUARE . 1 +"d THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 ** VOUCHER, DELIVERY MEMO, PACKING SLIPS,
^�J 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
21712014 . County Fiber Ring Support
HHPA-Technology Oversight Board Carmel Communications
VENDOR
SHIP Terry Crockett .`'
33 North 9th Street, Suite 215 TO 3 Civic Square .
. Noblesville, IN 46060 Carmel, IN 46032
• (317)571-2567
•
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHTTM
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-515.01
1 Each 2014 HHPA-TOB Dues $25,850.00 $25,850.00
Sub Total: $25,850.00
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Send Invoice To: •
City of Carmel
Terry Crockett
3 Civic Square
Cannel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT . PROJECT ACCOUNT I AMOUNT
1202 Carmel IS Dept. PAYMENT $25,850.00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
. . NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND•
1 VOUCHER HAS THE PROPER SWORN AFFIDAVITATT3C`LED. -•
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATEDBALANCE IN
THIS APP•••- IONS - NT TO PAY FOR THE.:ae .e.-DER. ,
•SHIP REPAID. •
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY -a ��/� , ' / / •
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. Director
T
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ■ �
DOCUMENT CONTROL NO. 31681 CLERK-TREASURER .
OFFICE COPY