101452 HOOSIER PORTABLE RESTROOMS INC a INDIANA RETAIL TAX EXEMPT Page 1 of 1
Citof IIairirinie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101452
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
2128/2018 354857 SKATING RINK UNITS
HOOSIER PORTABLE RESTROOMS INC Community Relations
VENDOR 2201 E 99TH ST SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46280-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
23752
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1203 Fund: 101 General Fund
Account: 43-590.03
1 Each UNIT AND HANDWASHING STATION FOR EVENT $11,250.00 $11,250.00
Sub Total $11,250.00
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Send Invoice To: z ' `�
Community Relations
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $11,250.00
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 /f, kn sn�di J.
1,6,a- "`O .,....,"et
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY \�
Nancy Heck James Crider \
TITLE Director Administration ..5V
CONTROL NO. 101452 CLERK-TREASURER