37760 Black Dog Home Improvements INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
( Carmel PURCI-{ASE ORDER NUMBER
A!- J 11 FEDERAL EXCISE TAX EXEMPT 37760
35-60000972
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
11/5/2014 11101/14 3298 Central Park North Campus building repairs
Black Dog Home Improvement LLC - Bryce Bale Parks Maintenance
165 Springvalley Drive 1427 E. 116th Street ATTN: Courtney
VENDOR Anderson, IN 46011 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Wood trim and roofing repairs to the shed behind the $ 1,935.0000 $ 1,935.00
Administration Office. Please see quote for more details.
(Amount below is NTE $1,935.00)
1.000 each Trim, roofing and siding repairs to the horsebarnfstorage $ 1,1 55.0000 $ 1,155.00
building behind the Administration Office. See quote for more
details. (Amount below is not to exceed $1,155.00)
GLAccount# 1125413-4350100
Send Invoice To:
$3,090.00
PLEASE INVOICE IN DUPLICATE
DEPAR!WENT ' ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART or THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT THERE IS AN UNODLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.OD SHIPMENTS CANNOT BE ACCEPTED,
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS- ORDERED BY Courtney Weintraut �.` � /L�
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 37760 ','d=ND; (''-":C'P"