51365 MIRACLE RECREATION EQUIPMENT INDIANA RETAIL TAX EXEMPT PAGE 1
City I .., a r m e CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 51365
35-60000972
ONE CMC SQUARE
CARMEL,!U`USEANA 46032-2ES4 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
5/18/2018 05/19/18 16307 353472 River Heritage playground replacement parts
Miracle Recreation Equipment C Parks Maintenance
PO Box 204757 1427 E. 116th Street ATTN: Courtney
VENDOR Dallas,TX 75320-4757 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each 984355BL BLue square deck section $963.0000 $963.00
1.000 each HW987897-1 Hardware Package 71452839 L1/2 $91.0000 $91.00
1.000 each HW987897-2 Hardware Package 71452839 L2/2 $28.0000 $28.00
1.000 each freight to 46032 $ 170.0000 $ 170.00
1.000 each 714758B Panel vision adventure below deck $ 1,761.0000 $ 1,761.00
1.000 each 713945 Convex round Acrylic Mirror 26-1/2"diam $290.0000 $290.00
24.000 each 304135 lag screw ss button head torx#10x1" $0.3400 $8.16
24.000 each 117049 washer#12 9/16 seal bondl8-8 ss $0.2200 $5.28
24.000 each 200083257 washer rubber reinforced 90131 al 03 $0.2600 $6.24
1.000 each 116021 Miracle label id generic $0.3200 $0.32
GLAccount#1125418-4237000
Send Invoice To:
$3,323.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 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 Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE ��
CLERK-TREASURER ��
DOCUMENT CONTROL NO. 51365 VENDOR COPY