101569 PATRIOT ENGINEERING & ENVIRONMENTAL INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of CI . urirrie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101569
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
4111/2018 361862
PATRIOT ENGINEERING&ENVIRONMENTAL Redevelopment Commission
VENDOR 6330 E 75TH ST,SUITE 216 SHIP 30 W Main Street,Suite 220
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46250--2700 Micheal Lee (317)571-2788
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24962
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 902 Fund: 902 Carmel.Redevelopment Fund
Account: 44-608.05
1 Each Geotechnical engineering investigation for hotel $4,350.00 $4,350.00
Sub Total $4,350.00
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Send Invoice To: :..��. §`v°w
Redevelopment Commission " S3
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Michael Lee `
30 W Main Street,Suite 220 "
Carmel, IN 46032-
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(317)571-2788 PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $4,350.00
•NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY 1Henry Mestetsky
TITLE
CONTROL NO. 101569 CLERK-TREASURER