101214 KIESER CONSULTING GROUP City
INDIANA RETAIL TAX EXEMPT Page 1 of 1
CERTIFICATE
FEDERAL EXCISE TAX EXEMPT O PURCHASE
O 1 2 1 A 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
12/28/2017 371213
KIESER CONSULTING GROUP LLC Clerk-Treasurer's Office
VENDOR 9120 OTIS AVENUE SUITE 103 SHIP : 1 Civic Square
TO
Carmel, IN 46032-
INDIANAPOLIS,IN 46216-
PURCHASE ID • BLANKET CONTRACT PAYMENT TERMS FREIGHT
22108 •
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1701 Fund: 101 General Fund
Account: 43-404.00
1 Each Fixed Capital Assets Inventory Report $1,500.00 $1,500.00
Sub Total $1,500.00
Send Invoice To: • $X
Clerk-Treasurer's Office
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,500.00
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
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ,C(i4
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dianne Walthall
TITLE Director of Financial Reporting
CONTROL NO. 101214 CLERK-TREASURER14\