101770 ICEBUILDERS SUPPLY, INC INDIANA L TAX EXEMPT Page 1 of
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I1.it ®f I c�jrjr] ] 1 CERTIFICA EENO!003 201 5 002 0 PURCHASE ORDER1NUMBER
( FEDERAL EXCISE TAX EXEMPT 101770
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
7/9/2018 372565
ICEBUILDERS SUPPLY, INC. Human Resources
VENDOR 4628 CROSSROADS PARK DR. SHIP 1 Civic Square
TO Carmel, IN 46032-
LIVERPOOL, NY 13088 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
27329
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 922 Fund: 922 Ice Rink Fund
Account: 50-239.90
1 Each Capital Outlay $9,715.00 $9,715.00
Sub Total $9,715.00
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Send Invoice To:
,
Human Resources
1 Civic Square
Carmel, IN 46032- '
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $9,715.00
SHIPPING INSTRUCTIONS '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
SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 4.--t7 C -a
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
James Crider James Crider
TITLE Administration Administration ^
CONTROL NO. 101770 CLERK-TREASURER ` \\