51491 DALLAS MIDWEST LLC INDIANA RETAIL TAX EXEMPT PAGE 1
` CERTIFICATE NO.003120155 002 0
PURCH5149A1SE ORDER NUMBER
a "" � FEDERAL EXCISE TAX EXEMPT
35-60000972
011E CMC SQUARE
CARMEL,IID IIA 4x.22-2ss4 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
6/5/2018 05/23/18 16401 370563 Additional Picnic table for Central Park East
Dallas Midwest LLC MCC-West
4100 Alpha Rd Suite 111 1235 Central Park Drive East
VENDOR Dallas,TX 75244 SHITOP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each F10214-8' Picnic Table Top/Seat:Weathered Wood $ 1,149.0000 $ 1,149.00
Frame:Black
1.000 each Shipping $ 160.0000 $ 160.00
GLAccount#1125404-4239000
Send Invoice To:
$ 1,309.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• AM 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 Courtney Weintraut
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 51491
VENDOR COPY `'