103046 BLUE GRASS FARMS INC ity
(j�'� INDIANA RETAIL TAX EXEMPT Page 1 of 1
Cof I2Ir]r1nIe1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
JL FEDERAL EXCISE TAX EXEMPT 103046
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
8/1/2019 00351585
BLUE GRASS FARMS, INC. Dept of Community Service
VENDOR 1915 W.53RD STREET SHIP 1 Civic Square
TO Carmel, IN 46032-
ANDERSON, IN 46013-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
38507
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 44-624.00
1 Each Trees $59,500:00 $59,500.00
Sub Total $59,500.00
SCANNED.
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` AUG 12019. N Send Invoice To: y ` �� '
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Dept of Community.Service Not to exceed $59,500 00
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1 Civic Square
Carmel, IN 46032- , ' ��
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $59,500.00
SHIPPING INSTRUCTIONS •ANP 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 `
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY \v
Mike Hollibaugh James Crider
TITLE Director Administration 4 70-
CONTROL NO. 1 03046 CLERK-TREASURER