51751 BELSON OUTDOORS LLC ' $ TE NO 003120155 002 PAGE��� INDIANA RETAIL TAX EXEMPT G 1
CERTIFICATE 0 PURCHASE ORDER NUMSER
FEDERAL EXCISE TAX EXEMPT 51751
35-60000972
ONE CIVIC SQUARE
CARMEI:,:IFIO1ANA i 6032-2584 I THIS NUMBER MUST APPEAR ON INVOICES.A/P
1 • g VOUCHER DELIVERY MEMO.PACKING SLIPS.
j FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE i DATE REQUIRED REQUISITION NO. VENDOR NO. j DESCRIPTION
7/27/2018 107125/18 17172 . 1A0_9 affackd 1Bike racks for Monon Greenway
Belson Outdoors LLC 372,iedi Parks Maintenance
627 Amersale Drive1427 E. 116th Street ATTN:Courtney
VENDOR TOP Carmel,IN 46032
Naperville,IL 60563
_
CANFlRMATION[. BLANKET. I CONTRACT PAYMENT TERMS FREIGHT
I
QUANTITY I UNIT OF MEASURE DESCRIPTION I UNIT PRICE EXTENSION
8.000 • each 'U'Stainless steel bike rack-CBBR-2UR-SSD Surface Mount $145.0000 $1,160.00
1.000 each Shipping $228.7800 $228.78
_ GLAccount#1125416-4239000
Send Invoice To:
$1,388.78
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT r - PROJECT I PROJECT ACCOUNT .f AMOUNT
PAYMENT
• AJP 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.0.0 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. 51751 VENDOR COPY \\4t)