37390 Belmont GraphicsCity lof Carme
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
1VFCIw� IAEBALYXCISE TAX EXEMPT
35- 30000972
JUL 2 b 2014
FORM APPROVED BY STATE BOARD OF ACCOUNTS FO4gyF OF CARMEL - 1997
PAGE 1
PURCHASE ORDER NUMBER
37390
THIS NUMBER MUST APPEAR ON INVOICES, AIP
VOUCHER, DELIVERY MEMO. PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
7/25/2014
07/26/14
2370
Founders Pavilion External Name & Address Sign
Belmont Graphics LLC
6529 West 350 South
VENDOR Portland, IN 47371
SHIP
TO
MCC - East
1235 Central Park Drive East
Carmel, IN 46032
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
1.000
each
DESCRIPTION
17 "w x 11 "h graphic printed face applied to printed 1" PVC;
flush mount; 4 "x4" alum post and back plate prime and powder
coat to match SW6720 Paradise; PMS 364 & 547; top of post
to hit 3'; in dirt
UNIT PRICE
EXTENSION
$ 800.0000
$ 800.00
1.000 each 17 "w x 4"11 graphic printed face applied to printed 1" PVC; flush $ 400.0000 $ 400.00
mount; below item #1 with 2" space between
GLAccount# 1060000- 5023990
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT
PROJECT
Io6 --5O CARD
SHIPPING INSTRUCTIONS
• SHIP REPAID-
. COD SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS.
• THIS ORDER ISSUED 94 COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
$ 1,200.00
PROJECT ACCOUNT
AMOUNT
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER 15 MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
AFFIDAVIT ATTACHED.
. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY
TITLE
CLERK - TREASURER
DOCUMENT CONTROL NO. 37390 VENDOR COPY
Lindsay Labas