26281 Bridesmith, Inc INDIANA RETAIL TAX EXEMPT PAGE
City o f Carmel l CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
City FEDERAL EXCISE TAX EXEMPT
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, MP
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. DESCRIPTIO
VENDOR SHIP ,3"
5292012 TO
Bridgesmith, Inc. Street Department
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS gArrr1 W 111 at q}•npt FREIGHT
4149 SR 43 Carmel, IN 46074
QUANTITY T• M '5 e• DESCRIPTION r ki UNIT PRICE EXTENSION
Account 0043-509.00 N/
1 Each concrete repair/Keystone wa $2,400.00 $2,400.00
0
4 Sub Total: $2,400.00
Oh
c3 IN 5 Via
Send Invoice To: r uU G
'ry
PLEASE INVOICE IN DUPLICATE
Strcct Department
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
3400 W. 131st Street
PAYMENT
Carmel, IN 46074- NF 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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I- HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
FgtreYIBM @i @PPO W6AFOT D $2,40000
ORDERED BY
•.PURCHASE ORDER NUMBER MUST APPEAR ON ALL
1' T7 I 'n 'Y
SHIPPING LABELS
r l -`/JX
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE -1 PLO 1 L /1 `t '�l V
pl 14
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. J 0
2 6 2 8 1 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY