51076 HUNGER SKATEPARKS LLC INDIANA RETAIL TAX EXEMPT PAGE 1
Cit y ^ Carmel l CERTIFICATE NO.003120155 002 0
{ PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPt 51076
35-60000972
ONE CMC SQUARE
CARMEL,1101.,'lUA 4e-32_2E84 THIS NUMBER MUST APPEAR ON INVOICES,NP
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
•
3/21/2018 03/26/18 15698 368336 2018 Skate Park Annual Maintenance Repairs
Hunger Skateparks LLC Parks Maintenance
7438 Lampkins Ridge Road 1427 E. 116th Street ATTN: Courtney
VENDOR Bloomington, IN 47401 So P Carmel, IN46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each Skate Park Repairs per attached Engagment Letter $2,500.0000 $2,500.00
GLAccount#1125404-4350400
•
Send Invoice To:
$2,500.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• /UP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART OF THE VOUCHE AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THA THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SNAP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.0.0 SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Michael Allen
• '1I IIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 51076 VENDOR COPY 4\X �'�