51883 BROOKFIELD SAND & GRAVEL INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE N i,r03120155 002 a
City a f ""rule
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
51883
35-60000972
01IE CIVIC SQUARE
CARMEL,f'ILDLAIIA 4,S032-25S4 THIS NUMBER MUST APPEAR ON INVOICES,NP
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
8/30/2018 09/02/18 17526 367408 Sand for playground at Founders
Brookfield Sand&Gravel, Inc. Parks Maintenance
8587 N 850 West 1427 E. 116th Street ATTN: Courtney
VENDOR Fairland, IN 46126 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
8.000 ton Mason sand including delivery $37.7500 $302.00
GLAccount#1125401-4239000
1
Send Invoice To:
$302.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• 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
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. \\"C\
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Neil Whitehead /� \\\yV
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /•L ``
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE `-:\ l
CLERK-TREASURER
DOCUMENT CONTROL NO. 51883 VENDOR COPY