26294 Gridlock Traffic SystemsCity of a acne],
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
THIS NUMBER MUST APPEAR ON INVOICES ASP
VOUCHER2T9. RY MEMO, PACKING SLIPS.
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
Indiarapolis,
IN
46226
(317)733 -2001
• 8/22/2012
VENDOR
Gridlock Traffic Systems
SHIP
TO
Street Department
3400 W 131st Street
CONHFbWT1ON
4-.4.44
BLANKET
,CONTRACT
..+.a aa•la\Yy
PAYMENT TERMS
4�..:�.,.. T
FREIGHT
Indiarapolis,
IN
46226
(317)733 -2001
OUANTITY (UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 0043.603.00
1 Each Paint total
Send Invoice To:
Street Department
3400 W. 131st Street
DEPAit1.T-,MBNO8, 1N 46674- ACCOUNT
PLEASE INVOICE IN DUPLICATE
PROJECT
Carmel Stme1PPfn3}NSTFrUCTIONS
• SHIP REPAID.
• C.O,D, SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE OROER NUM PER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 26294
ORDERED BY
, TITLE
CLERK - TREASURER
OFFICE COPY
$39,864.34
Sub Total:
PROJECT ACCOUNT
PAYMENT
• AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE ••RANT OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS T )ROPER SWORN AFFIDAVIT ATTACHED$39.804 -34
• I HEREBY CERTII Y,T11I IS AN UNOBLIGATED BALANCE IN
THIS APPROPHIATI�C'((�T$U FICIENT TO PAY FOR THE ABOVE ORDER.
•
$39,804.34
$39,804.34
AMOUNT