26262 Carmel Clay School-fuel payment l
0 INDIANA RETAIL TAX EXEMPT PAGE
City of C arme l CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
�1•� FEDERAL EXCISE TAX EXEMPT
35- 60000972 UUS�TT �f
ONE INDIANA A 46032-2584 VOUCHER, DELIJRfl%MO. PACKING SLIPS, AR ON INVOICES, MP
CARMEL, INDIANA 46032 -2584 E
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
12120/2011
SHIP
VENDOR 4 Carmel Clay Schools TO Street Department
3400 W. 131st Street
5201 E. 131st Street Carmel, IN 46074
CONFIRMATION BLANKET CONTRACT lil 46033 PAYMENT TERMS (317) 733 2001 FREIGHT
QUANTITY' UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Account 0042413.00
1 Each diesel $31,785.10 $31,785.10
Sub Total: $31,785.10
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Send Invoice To:
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Street Department
3400 W. 131st Street PLEASE INVOICE IN DUPLICATE
DEPARTME -1 lllel IN 46074- ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
CarmeLStreetDe artment NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AkE81 ,705.10
P VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. VV�u
SHIPPING INSTRUCTIONS I HEREBY CERTIFY TWIT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO CIENT TO PAY FOR TH ABOVE ORDER.
SHIP REPAID. //6 T
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL A ivi[_
SHIPPING LABELS. //�7i
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE /O r�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 26262 CLERK TREASURER
OFFICE COPY