31877 Gridlock Traffic SystemsCity ®f , ammeJ
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
$k 6%CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
31877
THIS NUMBER MUST APPEAR ON INVOICES. NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
712212014
VENDOR
Gridlock Traffic Systems
6400 Massachusetts Avenue
Indianapolis, IN 46226
SHIP
TO
Street Department
3400 W. 131st Street
Carmel, IN 46074
(317) 733 -2001
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 0043 - 503.00
1 Each Thermoplastic total
Send Invoice To:
Street Department
3400 W. 131st Street
Carmel, IN 46074-
•
PLEASE INVOICE IN DUPLICATE
$86,795.00
Sub Total:
$86,795.00
$86,795.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Carmel Street Department
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY
TITLE
PAYMENT $86,795.00
• 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.
I HEREBY CERTIFY LHAT THERE -IS'AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIONS PICIENT TO PAY FOR THE HOJE ORDER.
CLERK - TREASURER
DOCUMENT CONTROL NO. 31877 A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE