101523 THE HOOSIER COMPANY INC o INDIANA RETAIL TAX EXEMPT Page 1 of 1 ll
I }� of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXE PT 1 01 523
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
3/16/2018 360022 Vorte111*MA w/25 lamp wireless solar arrowboard
THE HOOSIER CO INC Street Department
;VENDOR P 0 BOX 681064 SHIP 3400 W. 131st Street
I TO Carmel, IN 46074-
INDIANAPOLIS, IN 46268- (317)733-2001
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
24267
I QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account: 44-670.00
1 Each Vorteq-TMA w/25 lamp wireless solar arrowboard $19,745.00 $19,745.00
Sub Total $19,745.00
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Send Invoice To: ' ��
Street Department i!
3400 W. 131st Street p� ,
Carmel, IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT PROJECT 1 PROJECT ACCOUNT AMOUNT
PAYMENT $19,745.00
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.0 D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR H ALL SHIPPING LABEL /� , �,
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /. `—�t—�/G/
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dave Huffman James Crider
TITLE Director Administration
CONTROL NO. 101523 CLERK-TREASURER
i