38736 Musselman FarmsCi tv of Carmel
ONE Crile SQUARE..
CARI1 I IND141 $n 72-2ES4
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 1
PURCHASE ORDER NUMBER
38736
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
6/23/2015
06/28/15
5757
Change: Safety surfacing for Carey Grove playground
Musselman Farms
17505 Durbin Road
VENDOR Noblesville, IN 46060
SHIP
TO
Parks Maintenance
1427 E. 116th Street ATTN: Courtney
Carmel, IN 46032
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
62.000
UNIT OF MEASURE
each
1.000 each
Send Invoice To:
DESCRIPTION
Playground safety surfacing for Carey Grove Park playground
GLAccount# 1125403-4239000
Approximate Delivery Fee
GLAccount# 1125418-4239000
PLEASE INVOICE IN DUPLICATE
UNIT PRICE
EXTENSION
$ 21.0000
$ 1,302.00
$ 150.0000 $ 150.00
$ 1,452.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
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.
DOCUMENT CONTROL NO. 38736
PAYMENT
• /VP 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 THIS APPROPRIATION
SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY Dawn Koepper �k 41 Ca23\15
TITLE
CLERK -TREASURER
VENDOR COPY