101557 HEARTWOOD ENTERPRISES INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101557
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
416/2018 367567 Capstones at Monon Tunnel on 126th St.
HEARTWOOD ENTERPRISES Street Department
VENDOR 3317 WEST 96TH STREET SHIP 3400 W. 131st Street
TO Carmel,IN 46074-
INDIANAPOLIS, IN 46268- (317)733-2001
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24835
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account: 43-509.00
1 Each Capstones at Monon Tunnel on 126th St. $97,625.00 $97,625.00
Sub Total $97,625.00
Ti
Y $
Send Invoice To: � ! "
Street Department
3400 W. 131st Street
Carmel, IN 46074= _ 044,
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $97,625.00
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 Oat zw-- C'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dave Huffman James Crider
TITLE Director Administration Ali
CONTROL NO. 101557 CLERK-TREASURER Y�