51167 HAMILTON DISC GOLF UNION, LTD INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
it
. of
(t(, �; FEDERAL EXCISE TAX EXEMPT 51167
35-60000972
OWE CMC SQUARE
CARMEL.IUDIAW'A 48032-2E84 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
4/11/2018 04/15/18 15895 369472 2018 Annual Maintenance- Hazel Landing&Lawrence W.
Inlow Park Disc Golf Course
Hamilton Disc Golf Union, LTD Parks Maintenance
11138 Meadows Drive 1427 E. 116th Street ATM: Courtney
VENDOR Fishers, IN 46038 SHIP
HP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
5
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
6.000 each Maintainance 5/1/18-4/30/19 $867.0000 $5,202.00
GLAccount#1125410-4350400
•
Send Invoice To:
$5,202.00
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 ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. 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 Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE 1 \.1‘\.e).,
r6(
CLERK-TREASURER ,w\
DOCUMENT CONTROL NO. 51167 VENDOR COPY