51794 AUTOMATIC IRRIGATION SUPPLY CO INDIANA RETAIL TAX EXEMPT PAGE 1
C 4, 1 crmel CERTIFICATE N0.003120155 002 0
i PURCHASE ORDER NUMBER
�•' "' FEDERAL EXCISE TAX EXEMPT
51794
35-60000972
ONE CMC SQUARE
CARMEL,INDIANA 46032-2E84 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
8/7/2018 08/07/18 17311 00350801 Backflow and well head decorative covers
Automatic Irrigation Supply Co Parks Maintenance
P.O. Box 2879 1427 E. 116th Street ATTN: Courtney
VENDOR Indianapolis, IN 46206-2879 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Dekorra Rock Model 116-color: Fieldstone Gray $279.6000 $279.60
1.000 each Dekorra Rock Model 102-Color: Fieldstone Gray $ 109.2900 $ 109.29
GLAccount#1125404-4239000
Send Invoice To:
$388.89
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 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. 51794 VENDOR COPY `1‘
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