51081 MIRACLE RECREATION EQUIPMENT INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0City ?,o amt
FEDERALPURCHASE ORDER NUMBER EXCISE TAX EXEMPT 51081
35-60000972
ONE CIVIC SQUARE
CARMEL TUDIA11.=,4.6V2-2c54. THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
3/23/2018 03/26/18 15704 353472 Replacement parts for Carey Grove playground equipment
Miracle Recreation Equipment C Parks Maintenance
PO Box 204757 1427 E. 116th Street ATTN: Courtney
VENDOR Dallas,TX 75320-4757 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each Replacement playground parts for Carey Grove as per quote $3,173.8100 $3,173.81
#1803091100BC: Overhead climber assembly, climber mast
assembly, Rockite slide hood,warning labels and freight
included.
GLAccount#1125403-4237000
Send Invoice To:
$3,173.81
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• A/P 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 ATrACHED.
• SHIP REPAID. • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
TITLE
CLERK-TREASURER V ?i
DOCUMENT CONTROL NO. 51081 VENDOR COPY ��