101046 INDIANAPOLIS CONCRETE CINDIANA RETAIL TAX EXEMPT Page 1 of 1
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CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101046
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL,INDIANA 46032-2584 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
12/11/2017 367400 Repairs to 136th/Springmill
INDIANAPOLIS CONCRETE Street Department
VENDOR 5363 W 86TH ST SHIP 3400 W. 131st Street
TO.
Carmel, IN 46074-
INDIANAPOLIS, IN 46268-
- (317)733-2001
PURCHASE ID BLANKET CONTRACT _ PAYMENT TERMS FREIGHT
21488
QUANTITY UNIT OF MEASURE • DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account:_43-509.00
1 Each Repairs to roundabouts
$2,150.00 $2,150.00
Sub Total $2,150.00
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Send Invoice To:
Street Department
3400 W. 131st Street
Carmel, IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $2,150.00
SHIPPING INSTRUCTIONS •NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
'SHIP PREPAID. 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
*C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL /J
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 1/43e.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dave Huffman `^
TITLE Director
CONTROL NO. 101046 CLERK-TREASURER \V N4)‘,