36979 Grunau Company City Carmel INDIANA RETAIL TAX EXEMPT PAGE t
CERTIFICATE NO.903120155 002 9
- -- -- .—
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 36979
35-60900972
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 — —
5/7/2014 05/11/14 1412 36005 Pull Stations for Founders Park Pavilion
Grunau Company of Indiana LLC Administration Office
4341 West 96th Street 1411 E. 116th Street
VENDOR Indianapolis, IN 46268 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE J EXTENSION
3.000 each Pull Stations $ 141.90 $425.70
1.000 each Approximate Installation Charge $ 170.00 $ 170.00
1.000 each Approximate Shipping $25.00 $ 25.00
G LAcco u n h4 1060000-5023990
Send Invoice To:
$ 620.70
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
I 0 r,'' - PAYMENT
` • AlP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
I PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
f 014 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS � '`ar1?� � 8 2 t;14
. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. .-. r SUFFICIENT TO PAY FOR THE ABOVE ORDER.
fSrt ;
C.O.O SHIPMENTS CANNOT BE.ACCEPTED. -- --- ; c's.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL,SHIPPING LABELS. ORDERED BY Dawn Koepper ak_,_w kil'#f �,` j I ti r
• AILS ORDER ISSUED IN COMP!-IANCE WITH CI IAPI-ER 99,AC1 S 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMI_NT 1HLTRI:TO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36979 vL•-;E%k I-'v?•.)'