30566 Most Dependable Fountains, Inc Carmel Clay CERTIFICATE RETAIL AX EXEMPT
PAGE
J RTIFICATE N0. O. D03120155 t55 00 002 0 PURCHASE ORDER NUMBER
Parks &Recreation FEDERAL EXCISE TAX EXEMPT 30566
35- 60000972
1411 E 116 Street THIS NUMBER MUST APPEAR ON INVOICES, NP
Carmel, IN 46032 VOUCHER, DELNERY 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
03/15/12 M000681 35`1037 Spare Parts for Fountain
Most Dependable Fountains, inc. Maint �Q
VENDOR PO Box 5 87 SHIP TO) WargE 0
AiaLINGTON TN 3e302- TO I I I 1 MAR 1 5 2012 0
p�/
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS B FCEIGH.T
QUANTITY I UNIT OF MEASURE DESCRIPTION 1 UNIT PRICE 1 EXTENSION
3 EA Oring Valve with 0 Ring assembly complete $102.00 $306.00
2 EA Whistler Valve 305b -2 -3 $52.00 $104.00
1 EA 5/16 Driver $28.00 $28.00
Send Invoice To:
$438.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I._ ACCOUNT PROJECT 1 PROJECT ACCOUNT AMOUNT
1125 -4 -01- 4237000- Repair Parts PAYMENT
AA' VOUCHER CANNOT BE APPROVPO FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORD AFFIDAVIT ATTACKED,
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE 15 /N UNOBLIGATED BALANCE IN
SHIP REPAID
THIS APPROPRIATION SUFFICIENTD PAY FOR THE ABOVE ORDER
C.O.O. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY Todd Snyder DK .j_1L .c) Z
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 30566 VENDOR COPY