26531 A & F Engineering C ®f Carmel INDIANA RETAIL TAX 0 PAGE
City CERTIFICATE NO. 003120155 00 00
CE 2 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2 1 .El
35- 60000972 J�
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AP
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
/�S C Erie, r.03 -v
SHIP
VENDOR TO 1't.- O( I C
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT J
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
o_ cY OR o.C
Zr: I C 1/4
0
0,. 4
to a
"4O I
4 u CL
fl ,‘....s Invoice Ta: o'c6d 1
C7c� u
I Co, (oSS S 2o2 (z#
an I 211 -Rs-09 (z7ggg)
%9 12 29 20S- RSO9 (2S83(0)
1, SO F. al --N) 202 R4ol (2\}
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT ,I
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.0.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND k
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. I
SHIPPING INSTRUCTIONS I HEREBY CERTIFY/THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRig UFF GIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. r
C 0 SHIPMENTS CANNOT BE ACCEPTED. r• i
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. r
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 26531 OFFICE COPY
LETTER OF TRANSMITTAL
Date: March 3, 2011
To: Cindy Sheeks
Office of the Clerk Treasurer
From: Katie Neville
Dept. of Engineering
RE: Purchase order release
release From fund account PO
$6,655.57 202 R401 27505
$145,557.09 211 R509 27487 C(O
$34,288.29 203 R509 25836/
$4,308.21 202 R401 21779
Add all to PO 26531 for total of 190809.16
release From fund account PO
$208,850.00 211 R4462300 25835
Add to PO 25847 for total of 208,850.00
release From fund account PO
$91,000.00 202 R4462864 27480
Add to PO 26532 for total of 91,000.00