101087 CARMEL CLAY SCHOOLS-FUEL PAYMENT INDIANA RETAIL TAX EXEMPTPage 1 of 1
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CERTIFICATEFEDERAL EXCISE TAX EXEMPTO PURCHA101087
So 1087 NUMBER
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
12/13/2017 042595
CARMEL CLAY SCHOOLS-FUEL PAYMENT Street Department
VENDOR EDUCATION SERVICE CENTER SHIP 3400 W.131st Street
5201 E MAIN ST TO Carmel, IN .46074
CARMEL, IN 46033 (317)733-2001
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21670
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund:-2201 Motor Vehicle Highway FND
Account: 42-313.00
1 Each Diesel Fuel $117,700.00 $117,700.00
Sub Total $117,700.00
Send Invoice To:
Street Department
3400 W. 131st Street Carmel, IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT 0 PROJECT [ PROJECT ACCOUNT I AMOUNT
PAYMENT $117,700.00
SHIPPING INSTRUCTIONS '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
*SHIP PREPAID. 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 -
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 �� / l / � `--e C -
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dave Huffman James Crider \ •
TITLE Director Administration
CONTROL NO. 101087 CLERK-TREASURER \ +�`