32132 Legacy FUndcity of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
32132
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
12/12/2014
VENDOR
Legacy Fund
A CICF Affiliate
515 E. Main Street
Suite 100
Carmel, IN 46032
SHIP
TO
City of Carmel
Dept. of Community Relations &
Economic Development
One Civic Square
Carmel, IN 46032
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE I
DESCRIPTION
UNIT PRICE
EXTENSION
Support for the Carmel Youth Assistance Program
Send Invoice To:
1203/4359300
PLEASE INVOICE IN DUPLICATE
$50,000.00
$50,000.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• COD. 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.
DOCUMENT CONTROL NO. 32132
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
• ASP 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 CERTI HAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROP FICIENT TO PAY FO ,THE ABOVE ORDER.
Invoice Date: December 12, 2014
The Honorable James Brainard
City of Carmel
One Civic Square
Carmel, IN 46032
LEGACY
• FUND
A CIO: Affiliate
Inspiring philanthropy
Please call Terry Anker at 317 - 843 -2479 with any questions concerning this invoice.
Thank you in advance for your support of Legacy Fund
Legacy Fund EIN is 20- 0900981
Payment and a copy of the invoice should be sent to:
Legacy Fund
515 E. Main Street
Suite 100
Carmel, IN 46032
Legacy Fund
Invoice
Date
Amount
Due
12/12/2014
Support for the Carmel Youth Assistance Program
as described in PO #32132
$50,000.00
Total
$50,000.00
Please call Terry Anker at 317 - 843 -2479 with any questions concerning this invoice.
Thank you in advance for your support of Legacy Fund
Legacy Fund EIN is 20- 0900981
Payment and a copy of the invoice should be sent to:
Legacy Fund
515 E. Main Street
Suite 100
Carmel, IN 46032