102230 MITSCH DESIGN INC I1arimnnie1
INDIANA RETAIL TAX EXEMPT Page 1 of 1
City ®f CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102230
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
12/5/2018 372777 WORKPLACE FURNITURE
MITSCH DESIGN INC Community Relations
VENDOR 200 S RANGELINE RD SHIP 1 Civic Square
SUITE 226 TO Carmel,IN 46032-
CARMEL, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31703
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1203 Fund: 101 General Fund
Account: 44-630.00
1 Each WORKPLACE FURNITURE $3,951.16 - $3,951.16
Sub Total $3,951.16
N
Send Invoice To: .�,, __,
Community Relations �_°`'
1 Civic Square e �
rt,
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $3,951.16
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
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 —11,4"4-1e-(6,
� Q, �+ , 1.4.,a,_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Nancy Heck
TITLE Director \ 4
CONTROL NO. 1 02230 CLERK-TREASURER