31150 F E HardingCity of Carmel
ONE CIVIC SQUARE
cAAMEL, INDIANA 46032-2554
FORM APPROVED BY STATE BOARD CF ACCOUNTS FOR CITY OF CARMEL. - 1937
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35-60000972
PURCHASE ORDER L)AIL
DATE REOUIRLD
REDUISITION NO.
08/10/12
M000795
PAGE
PURCHASE ORDER HUMP ER
31150
rN15 NUMBER MUST APPEAR OH INVOICES. A.P
VOUCHER. DELIVERY IAEMG. PACKING SLIPS,
SIPPING LABELS AND ANT CORRESPOVDENCE.
VENDOR NO.
DESCRIPTION
Monon Greenway Crack Sealing
F.E. Harding Asphalt
VENDOR at s E H a@ue Rd
nCLI a spolIS,, Ihi 4%25(0
m ?FIFIW IGN ELANI(1:T
GUANTITY 1 UNIT or ME45URE I r
CONTRACT
PAYM @NT TERMS
SHIP
TO
Maint
AUG 10 2012
DESORPTION
UNIT PRICE EXTENSION
1
EA Area 1 - Crack Sealing per quote
EA Area 2 - Crack Sealing per quote
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
$450.00 $450.00
$500.00 $500.00
$950.00
DEPARTMENT
ACCOUNT
1125 -4 -16- 4350400- Grounds Maintenance
SHIPPING INSTRUCTIONS
• SOAR REPAID.
• C.O.D. setemteTS CANNOT BE ACCEPTED,
• PURCHASE WADER NUA5ER MUST APPEAR ON AIL
SHIPPING LABELS,
TFI90HOEF 155UEp 1!l COMPLI&NCE WITH CHARTER OS. ACTS".S 5 TIRE
AND ACTS AMENDATORY THEREOF AND SUPPLEr1ENI TIAEROI O.
31150
DOCUMENT CONTROL NO. VENDOR COPY
PROJECT I PROJECT ACCOUNT
PAYMENT
NP VOUCHER CANNOT BE APPROV;p POE PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOLICHCR HAS THE PROPER GVJCRJ AFFIDAVIT ATTACIISD.
• I HEREBY CERTIFT THAI TH$FE IS IN ONOELIGPTED BOUNCE IN
THIS APPROPRIATION SUFFICIENT TO PAY POR THE ABOVE ORDER.
AMOUNT
ORDERED DV John Gates - DK cs, .- }J 62L L_ 1,103 i �
CLERK - TREASURER