41101 SMITHGROUP, INC (2) INDIANA RETAIL TAX EXEMPT I PAGE 1
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CERTICATE 120155 0020
FEDERAL EXCISECISE T TAX EXEMPT PURCHASE ORDER NUMBER41101
35.60000972
ONE C_MC;SOUARE
CARMEL,INDANA4602584 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
8/14/2019 03/16/19 21121 373213 Change: West Park-The Groves Project
Administration Office
SmithGroup, Inc. 1411 E. 116th Street
SHIP VENDOR Carmel, IN 46032
201 Depot Street,2"d Floor TO
Ann Arbor, MI 48104
CONFIRMATION BLANKET " CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
$1.000 each Professional Services 485,000.000 $485,000.00
$1.000 each Reimbursables NTE 75,000.000 $75,000.00
$1.000 each 1st Amendment-Increase in construction budget,additional 80,000.000 $80,000.00
design,and docmentation required
$1.000 each 2nd Amendment-Changes to Scope of Services 23,790.000 $23,790.00
$1.000 each 3rd Amendment-Increase associated with the prep of the"as- 1,850.000 $1,850.00
built drawings for the City of Carmel water permit
$1.000 each 4thd Amendment-.Incr_a_e,(Extension of Contract 4,600.000 $4,600.00
Administration)
GLAccount#1060000-5023990
IOTA L (01O, 24 0.0
PREVIOU.5L 90
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I _ ACCOUNTI PROJECT .I,, _- PROJECT ACCOUNT I 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.
. COD SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Klepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER 0
DOCUMENT CONTROL NO. 41101 VENDOR COPY
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