51168-A GIBRALTAR CONSTRUCTION CORP INDIANA RETAIL TAX EXEMPT PAGE 1
' CERTIFICATE NO.0031201550020Cannel
FEDERAL EXCISE TAX EXEMPT PURCHASE ORDER NUMBER
35-60000972
ONE CIVIC;SQUARE
CARMEL,INDIANA 46632-2584 THIS NUMBER MUST APPEAR ON INVOICES,All.
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
5/10/2018 05/15/18 16265 372371 Change:West Park-The Groves Rebid Project
Gibraltar Construction Corp Administration Office
2932 N Webster Ave 1411 E. 116th Street .. . . .
VENDOR Indianapolis, IN 46219 SHIPTO Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT - . . PAYMENT TERMS ." - FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
$ 1.0000 _ each Contract Services for West Park-The Groves Rebid Project 5,558,500.000 $5,558,500.00.
$ 1.0000. each Change Order#001 -NTE(Chemical and Mechanical . 299;996.000 $299,996.00
Stabiliaztion of Soils)
GLAccount#1060000-5023990
pokeA
11011231
?or (K.
Send Invoice To:
$5,858;496.00'''
PLEASE INVOICE IN DUPLICATE .. \4t
DEPARTMENT I ACCOUNT PROJECT '"PROJECT ACCOUNT AMOUNT0
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 ONALL SHIPPING LABELS. ORDERED BY Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 . .. . . _
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 51168 VENDOR COPY