51950 MUSSELMAN FARMS INDIANA RETAIL TAX EXEMPT I PAGE 1
•
CERTIFICATE NO.003120155 002 0
ofPURCHASE ORDER NUMBER
i � CdrmelL FEDERAL EXCISE TAX EXEMPT
51950
35-60000972
ONE CMC SQUARE
CARMEL, 1.14}(ANA4 C32-2c64 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
9/20/2018 09/24/18 17689 00352476 Playground Safety Surfacing for Meadowlark Park
Musselman Farms Parks Maintenance
17505 Durbin Road 1427 E. 116th Street ATTN: Courtney
VENDOR Noblesville, IN 46060 TOHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
•
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
80.000 yard Safety surfacing for playground at Meadowlark Park-Delivery $24.9600 $1,996.80
Included
1.000 yard Freight $200.0000 $200.00
GLAccount#1125414-4350400
•
Send Invoice To:
$2,196.80
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 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. 51950 VENDOR COPY