31872 Smock Fansler Ci0 City,,,,,, Carmel INDIANA RETAIL TAX EXEMPT PAGE
I \�/ o f 1\ .°sane PI CERTIFICATE NO.003120155 002 0
y �' �1/ wY PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 31872
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 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
5/16/2014
Smock Fansler Corporation Street Department
VENDOR
SHIP 3400 W. 131st Street
2910 W. Minnesota Street TO Carmel, IN 46074
Indianapolis, IN 46241-4541 (317) 733-2001
CONFIRMATION JQe<nRYeeNTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 0042-390.34
1 Each Roundabout Repair 126th / Shelborne $3,670.00 $3,670.00
Sub Total: $3,670.00
* 1:
Vc.t ,Icult -i\t.u\�h�ttc 1(-1 % I 'o) . 1
1 0
Send Invoice To: rl -- fj11 •
Street Department )Jl
3400 W. 131st Street
Carmel, IN 46074-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
Carmel Street Department PAYMENT $3,670.00
• NP 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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE SAN UNOBLIGATED BALANCE IN
THIS-APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. 1 / {/'//
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY /�� /i✓YJ/'-•-�---�
SHIPPING LABELS. / /,//,'1
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE P{ A+'lfv'/ /J f/O n r K•
•
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. -
DOCUMENT CONTROL NO. 318 72 CLERK-TREASURER
A.P.Y. COPY-SIGN AND RETURN TO CLERK'S OFFICE