101524 CUSTOM CAST STONE v INDIANA RETAIL TAX EXEMPT Page 1 of 1
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CERTIFICATE NO.00312015510020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101524
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584VOUCHER,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
3/19/2018 353580 Wall Caps
CUSTOM CAST STONE INC Street Department
VENDOR 734 E 169TH ST SHIP 3400 W. 131st Street
TO Carmel, IN 46074-
WESTFIELD, IN 46074- (317)733-2001
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24347
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1206 Fund: 101 General Fund
Account: 43-501.00
1 Each Wallcoping $967.00 $967.00
Sub Total $967.00
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Send Invoice To: ,
Street Department `4r
3400 W. 131st Street . .
Carmel, IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $967.00
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.
'THIS E SSUE IN BER MUST APPEAR H ALLSHIPPING
99,ACTS
LABEL /�����/
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 n,--"-
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dave Huffman
TITLE Director
CONTROL NO. 1015524 CLERK-TREASURER JJJ