102378 MCCOMAS ENGINEERING, INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
City ®f Iiirriii.e1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102378
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
12/13/2018 00350775 241 1st Ave SE
MCCOMAS ENGINEERING, INC Dept of Community Service
VENDOR 1717 E 116TH ST,SUITE 200 SHIP 1 Civic Square
TO Carmel, IN 46032-
CARMEL, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
32173
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-509.00
1 Each Engineering Services $3,000.00 $3,000.00
Sub Total $3,000.00
6
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Send Invoice To:
Dept of Community Service Not to exceed$3000.00 /'
1 Civic Square °
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT p PROJECT ACCOUNT AMOUNT
PAYMENT $3,000.00
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 \
60
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Mike Hollibaugh
TITLE Director \
CONTROL NO. 102378 CLERK-TREASURER