36870 Delello & Sons Asphalt Paving ity
INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0 I 'C a nI P PURCHASE ORDER NUMBER
(;� FEDERAL EXCISE TAX EXEMPT 36874
35-60000972
ONE CNIC SQUARE
CARMEL.INDIANA 46032-2534 THIS NUMBER MUST APPEAR ON INVOICES.A!P
VOUCHER,DELIVERY MEMO.PACKING SLIPS.
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
4/18/2014 04/22/14 1177 Asphalt repairs to outdoor park areas and drives
Delello&sons Asphalt Paving Parks Maintenance
17306 Westfield Park Road 1427 E. 116th Street ATTN: Courtney
VENDOR Westfield, IN 46074 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION
1.000 each Hazel Landing Entry Road -See quote for more details- Not $ 1,900.00 $ 1,900.00
to be started until May 5
80.000 each Hazel Landing Entry-Additional Stone up to 80 tons - Repair $ 14.50 $ 1,160.00
not to be started until May 5
1.000 each West Park entrance Path -See quote for more details -Work $ 1,200.00 $ 1,200.00
to complete before May 5,they need 1 week notice
1.000 each North Trailhead Parking lot-See quote for additional details $3,700.00 $3,700.00
1.000 each Central Park 9 asphalt cut patches and 2 mill patches-See $9,687.55 $9,687.55
quote for details. Price includes$500 for flaggersWork to
complete before May 5, they need 1 week notice
1.000 each White River Greenway trail patch-See quote for more details $ 1,500.00 $ 1,500.00
GLAccount# 1125401-4350400
Send Invoice To:
$ 19,147.55
PLEASE INVOICE IN DUPLICATE
DEPARTMENT L ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• AIP 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
. I HEREBY CERTIFY THAT THERE IS AN UNOBLICATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. G.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Courtney Schlaegel
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 95,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE L�� `1114 #1)(-1
CLERK-TREASURER AP
DOCUMENT CONTROL NO. 36870 VENDOR COPY