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31894 Precision Concrete CuttingCi of Cannel ONE CIVIC SQUARE CARMEL, INDIANA 46032 -2584 FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997 INDIANA RETAIL TAX EXEMPT ERTIFJCATE)NO. 003120155 002 0 FEDERAL EXCISE TAX EXEMPT 35- 60000972 PAGE PURCHASE ORDER NUMBER 31894 THIS NUMBER MUST APPEAR ON INVOICES, AP VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 11(2112014 VENDOR Precision Concrete Cutting 1896 Goldeneye Drive Holland, MI 49424 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 - 509.00 1 Each Sidewalk Trip Hazard Removal Send Invoice To: Street Department 3400 W. 131st Street Carmel, IN 46074- PLEASE INVOICE IN DUPLICATE $2,535.00 Sub Total: $2,535.00 $2,535.00 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. PAYMENT $2,535.00 • 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 THAT THERE IS AN UNOBLIGATED BALANCE IN 5 APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. ORDERED BY Ci.- I JJZ TITLE Hj (2 ' `0144 inn St ! h 14 e%_ DOCUMENT CONTROL NO. 318 94 CLERK- TREASURER A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE