102417 TRAVELERS INDIANA RETAIL TAX EXEMPT Page 1 of 1
Chitof Carnael CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102417
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12/14/2018 362876
TRAVELERS General Administration
VENDOR 13607 COLLECTIONS CENTER DRIVE SHIP 1 Civic Square
TO Carmel, IN 46032-
CHICAGO, IL 60693 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
32238
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1205 Fund: 101 General Fund
Account: 43-475.00
1 Each General Insurance $64,050.00 $64,050.00
Sub Total $64,050.00
SCANNED
DEC 1 8 2018
,�
Send Invoice To: _.. �
Dept of Administrations.
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $64,050.00
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 tic 4-.--4V�-�' :_c/tel
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
James Crider James Crider ti
TITLE Administration Administration
CONTROL NO. 102417 CLERK-TREASURER \ "k-