101265 OMNI CENTER FOR PUBLIC MEDIA City ® moo IIar]n1e1INDIANA RETAIL TAX EXEMPT Page 1 of 1
.ILL.
CERTIFICATE
FEDERAL EXCISE TAX EXEMPT 101265 PURCHASE101 2NUMBER
65
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ONIINNVOICES,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
1/9/2018 00350965 EQUIPMENT MAINTENANCE
OMNI CENTRE FOR PUBLIC MEDIA, INC Community Relations
VENDOR PO BOX 302 SHIP 1 Civic Square
TO Carmel, IN 46032-
CARMEL, IN 46082--0302
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22513
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1203 Fund: 101 General Fund
Account: 43-515.01
1 Each . EQUIPMENT MAINTENANCE $28,000.00 $28,000.00
Sub Total $28,000.00
.r}k
s
Send Invoice To: -�,
Community Relations
1 Civic Square -
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $28,000.00
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 -11_,Gt/w4cu:
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY DD
Nancy Heck James Crider `
TITLE Director Administration \
CONTROL NO. 101265 CLERK-TREASURER