51899 ACOFULCOM INVESTMENTS '•: INDIANA RETAIL TAX EXEMPT !PAGE 1
City of Cannel __.. ...._..__....... .,_,. _ _
..J ;PURCHASE ORDER NUMBER
I FEDERAL EXCISE TAX EXEMPT 51899
35-50000972
ONE CIVIC.SQUARE ?-..--.__..—___..._.._..._.._� __ _
CARL1EL,INDIANA 4c032 2EB�r THIS NUMBER MUST APPEAR ON INVOICES,A1P r
VOUCHER,DELIVERY MEMO,PACKING SLIPS.
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 _.............._...__....__..._....-._....____,_..._...._..............-................__.._._ i
PURCHASEOR .„_. .,_...,.._.__,.._............_._... ._.. -_.______-__._.................._.__._._
DER DATE I DATE REQUIRED REQUISITION NO. ( VENDOR NO. DESCRIPTION
9/5/2018 09/03/18 17538 372273 tA0 Conference Room Carpet Replacement
ACo/Fulcrum Investments Co. Administration Office
1000 3rd Ave.SW Suite 120 1411 E. 116th Street
VENDOR Carmel,IN 46032 To P Carmel, IN 46032
CONFIRMATION BLANKET ( CONTRACT I PAYMENT TERMS I FREIGHT
I
QUANTITY I UNIT OF MEASURE 1 DESCRIPTION L UNIT PRICE I EXTENSION
1.000 each Labor and Material to Replace AO Conference Room Carpet& $2,885.0000 $2,885.00
Padding
GLAccount#1125101-4463000
Send Invoice To:
$2,885.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT 7 PROJECT 1 PROJECT ACCOUNT i AMOUNT
PAYMENT
• AIP 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.
. Com SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
i :
DOCUMENT CONTROL NO. 51899
VENDOR COPY