102144 CARMEL CLAY SCHOOLS-FUEL PAYMENT INDIANA RETAIL TAX EXEMPT Page 1 of 1
Iit ' o (( arriT1 e1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
JL \ JL Jl FEDERAL EXCISE TAX EXEMPT 102144
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 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
I 11/21/2018 042595
1 CARMEL CLAY SCHOOLS-FUEL PAYMENT Dept of Community Service
VENDOR EDUCATION SERVICE CENTER SHIP 1.Civic Square
j 5201 E MAIN ST TO Carmel, IN 46032-
CARMEL, IN 46033-
1-
LPURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
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lI 31235
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QUANTITY
— UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 42-314.00
1 Each Fuel $3,873.28 $3,873.28
Sub Total $3,873.28
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Send Invoice To: ry
Dept of Community Service
1 Civic Square
Carmel, IN 46032-
_ PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $3,873.28
SHIPPING INSTRUCTIONS '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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
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'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY C
Mike Hollibaugh
TITLE Director `. `
CONTROL NO. 102144 CLERK-TREASURER (