52179 LEE SUPPLY CORP •
INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NAtLA3120155 002 0 •
• ltY
irmeIO "' , FEDERAL EXCISE TAX EXEMPT PURCHASE ORDER NUMBER
52179
35-60000972
OI•IE CMC'SQUARE •
• CA.RM-E- THIS NUMBER MUST APPEAR ON INVOICES,NP
VOUCHER,DELIVERY MEMO,PACKING SUPS,
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
11/28/2018 - 12/02/18 18245 184000 Faucet assemblies
Lee Supply Corp Parks Maintenance
P 0 Box 681430 1427 E. 116th Street ATTN: Courtney
VENDOR 'Indianapolis, IN 46268 THIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
.QUANTITY .UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
2.000- each 12001566634 ZURN Z6913-XL Lavatory Faucet $249.2200 $498.44
GLAccount#1125419-4238900
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Send Invoice To:
$498.44
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 \ A
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE , (�
CLERK-TREASURER
DOCUMENT CONTROL NO. 52179 VENDOR COPY