51494 LEE SUPPLY CORP INDIANA RETAIL TAX EXEMPT PAGE 1
C �. �r� �^� CERTIFICATE NO.003120155 002 0
CityIQ ! �irmtPURCHASE ORDER NUMBER
\!/ 4 1✓ FEDERAL EXCISE TAX EXEMPT 51494
35-60000972
ONE C[`JIC SQUARE
CARI4EL,!NENANA 460.22_2 $L THIS NUMBER MUST APPEAR ON INVOICES.A/P
VOUCHER,DELIVERY MEMO.PACKING SUPS,
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
6/6/2018 06/03/18 16551 184000 Restroom fixture replacements from vandalism
Lee Supply Corp Parks Maintenance
P 0 Box 681430 1427 E. 116th Street ATTN: Courtney
VENDOR Indianapolis, IN 46268 THIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
4.000 each z6913-xl-cp4-my Zurn sensor faucet $270.4500 $ 1,081.80
2.000 each tb103EZ insulation kit&trap 2valve $35.7000 $71.40
4.000 each u711-2436 channel frame mirror 10001522526 $55.9300 $223.72
GLAccount#1125404-4237000
2.000 each z6913-xl-cp8-my zurn sensor faucet $280.4700 $560.94
2.000 each tb103EZ insulation kit&trap 2valve $35.7000 $71.40
1.000 each kohler urinal k-4991-et-0 $ 128.4000 $ 128.40
1.000 each kohler k-96057 EL topspud WH ADA $81.6000 $81.60
1.000 each k-4731-c plastic EL OFLC seat HE $ 14.9500 $ 14.95
1.000 each 12001523274 Zurn Zer6000AV-het-cpm 1.28 GPF auto flush $326.6000 $326.60
valve
1.000 each 12001523272 zurn zer6003av-ulf-cpm .125 GPF automatic $326.6000 $326.60
flush valve urinal
2.000 each k20060 k-2006 21x18 wlhng lay wh 8'cc $49.1800 $98.36
1.000 each Estimated Shipping $250.0000 $250.00
GLAccount#1125419-4237000
Send Invoice To:
$3,235.77
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. 51494 . VENDOR COPY