51239 MUSSELMAN FARMS (2) INDIANA RETAIL TAX EXEMPT CPAGE 1
CERTIFICATE Na03120155 002 0
t o LL m ; PURCHASE ORDER NUMBER
1 FEDERAL EXCISE TAX EXEMPT 51239
35-60000972
011E CIVIC SQUARE
CARMEL,IIID AI1; X032-22ES4 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
4/25/2018 04/29/18 16063 00352476 Safety Surfacing for River Heritage
Musselman Farms Parks Maintenance
17505 Durbin Road 1427 E. 116th Street ATTN: Courtney
VENDOR Noblesville, IN 46060 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
40.000 yard Playground safety surfacing for River Heritage Park $24.9600 $998.40
2.000 each Shipping/Delivery Charge $50.0000 $ 100.00
GLAccount#1125418-4239000
Send Invoice To:
$ 1,098.40
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBUGATED 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 Courtney Weintraut `
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 `
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE \\Y
CLERK-TREASURER �J
DOCUMENT CONTROL NO. 51239 VENDOR COPY