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101263 MELROSE PYROTECHNICS INC II ity ®f Iairni.e1 INDIANA RETAIL TAX EXEMPT Page 1 7 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 101263 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AJP CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 1/9/2018 366315 NYE CELEBRATION FIREWORKS MELROSE PYROTECHNICS INC Community Relations VENDOR 1 KINGSBURY INDUSTRIAL PARK SHIP 1 Civic Square PO BOX 302 TO Carmel, IN 46032- KINGSBURG, IN 46345- PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 22511 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1203 Fund: 101 General Fund Account: 43-590.03 1 Each FIREWORKS CARMELFEST 2018 $25,000.00 $25,000.00 Sub Total $25,000.00 Account 43-593.00 1 Each FIREWORKS FOR NYE CELEBRATION $5,000.00. $5,000.00 Sub Total $5,000.00 4 Send Invoice To: Community Relations 1 Civic Square Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT $30,000.00 SHIPPING INSTRUCTIONS 'A/P 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 JL Ltn L�cc, - SCI cel 1 c c._f! -et 40 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY Nancy Heck James Crider \ TITLE Director Administration \\\ CONTROL NO. 1 01 263 CLERK-TREASURER