36983 Mattingly Concrete -, INDIANA RETAIL TAX EXEMPT PAGE 1
'gyp-" /- 1r C � ,,r •� / CERTIFICATE NO 0031 20155 002 0 i [ . T 0 1 a r � 1�[ _-__ _. _ _. __ PURCf1ASF Of2DEl2 NUM3EIT
1111 ll ` LLL 111 1 R LL \✓ FEDERAL EXCISE TAX EXEMPT 36983
35-60000972
,:'--."--.M_-_ - -•_ --, THIS NUMBER MUST'APPEAR ON INVOICES,NP
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
5/812014 05/04/14 1314 North Trailhead concrete bike pad
Mattingly Concrete Inc. Parks Maintenance
15936 Joliet Rd 1427 E. 116th Street ATTN: Courtney
VENDOR Westfield, IN 46074 SHIP Carmel, IN 46032
TO
CONE IRMA IION 131 ANKE I CONTRACT _ -—_T PAYMENT TERMS rRl-IGf IT
QUANTITY
_--,_-,'UNIT OF MFASUIdE- ^-_"-- _-_-..- DESCRIPTION_-_, —I__._.._ __ UNIT PRICE I ---- EXTENSION
1.000 --�_--
1.000 each Concrete pad installation at the North Trailhead -8'L x 5'W x $ 1,500.00 $ 1,500.00
4"D concrete pad -6 bag mix at 4000PSI with air and fiber-
brush finish
GLAccount# 1125416-4350400
Send Invoice To:
$ 1,500.00
PLEASE INVOICE IN DUPLICATE -
1)I7PAR7 MFN1 ACCOUNI p tP F,T"i PROJPCI ACCOUNT I
AMOUNT
I 12.5 43 5O(4OC F - I PAYMENT
MAY C i • AlP 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 I AFFIDAVIT ATTACHED.
BYBY. f
.__ — T . I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SHIP HIiPAID. "`"-"-"--------------- ---T SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.O I)5111 PMI.NTS CANNO I 13E ACCFP1ED. •
• PuNCIIASI-ORDER NUMBER MUST AP PEAR ON ATI.SHIPPING LABELS. ORDERED BY Courtney Schlaegel ILL, c , � jt S.\`y
• rills ORDER IssurD IN COMPLIANCE WI III cnnPrl=H ee.AC I s 1la�s
1I
AND ACTS AMI NOAI ORY THEREOF AND SUPPLUMUN I 1111_HI:1'0. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36983 -P.:■%!... ?4"':-..4r''
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