101777 FREDERICKS CONTRACTORS \
Iitx v INDIANA RETAIL TAX EXEMPT Page 1 of 1
of Iariiinie1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
1 FEDERAL EXCISE TAX EXEMPT 101777
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AQP
CARMEL, INDIANA 46032-2584 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
7/10/2018 361637 Repair Damage at EOC from Water Line Break
FREDERICKS CONTRACTORS Fire Department
VENDOR PO BOX 229 SHIP 2 Civic Square
TO Carmel, IN 46032-
PENDLETON, IN 46064-
PURCHASE ID I BLANKET I CONTRACT PAYMENT TERMS FREIGHT
I 27423
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-501.00
1 Each Repair Damage from Water Line Leak at EOC $10,430.00 $10,430.00
Sub Total $10,430.00
7
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Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT I PROJECT ACCOUNT AMOUNT 1
PAYMENT $10,430.00
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 _` "= ' A `' '' l
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder James Crider �V
TITLE Budget&Accreditation Manager Administration
CONTROL NO. 101777 CLERK-TREASURER