50875 ELLIS MECHANICAL INC i INDIANA RETAIL TAX EXEMPT PAGE 1 t
1 City
CERTIFICATEN00031201550020 PURCHASE ORDER NUMBER P
FEDERAL EXCISE TAX EXEMPT_ 50875 I
35-60000972 j
ONE CNICS.DUAAE ....... .
CAMEL,..1714NA484322E 84 THIS NUMBER MUST APPEAR ON INVOICES,NP I
VOUCHER,DELIVERY MEMO.PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE. I
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 '
PURCHASE ORDER DATE l DATE REQUIRED REQUISITION NO. VENDOR NO, DESCRIPTION NW
2/5/2018 02/10/18 15264 369349 Service Call-Leaking Water Line at AO Pool house
Ellis Mechanical,Inc. MCC-West
2929 Bluff Road 1235 Central Park Drive East
VENDOR Indianapolis, IN 46225
SH Carmel, IN 46032
CONFIRMATION I BLANKET 1 CONTRACT j PAYMENT TERMS I FREIGHT
a . I
QUANTITY I UNIT OF MEASURE I DESCRIPTIONUNIT PRICE EXTENSION
1.000 each Labor and Utility Locate Service-found no access $ 1,133.0000 $1,133.00
GLAccount#1125402-4235000
Send Invoice To:
$1,133.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT .PROJECT ACCOUNT AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
▪ C.O.0 SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper ]p�
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 �✓h
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
Is .- -4"'
CLERK-TREASURER
DOCUMENT CONTROL NO. 50875 VENDOR COPY