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26296 E & B Pavingof Carmel 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 at FEDERAL EXCISE TAX EXEMPT 35- 60000972 ./ PAGE PURCHASE ORDER NUMBER THIS NU UST APPEAR ON INVOICES, AR VOUCHER:luoECRERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. . VENDOR NO. DESCRIPTION N. Andel sulfa IN 916/2012 VENDOR ti '`E 8 B Paving a SHIP TO Street Department 3400 W. 131st Street 286 West 300 North Carmel, IN 451114 CONFIRMA ➢ON BLANKET CONTRACT' )'PAYMENT TERMS FREIGHT Andel sulfa IN (317) 733 2001 QUANTITY 1 UNIT OF MEASURE DESCRIPTION UNIT,PRICE EXTENSION Account 0043 - 802.00 1 Each 2009 Paving Program 1 Send Invoice TO: Street Department 3400 W. 131st Street rr PLEASE INVOICE IN DUPLICATE DEPA IN 48974- ACCOUNT $770,720.00 $770,720.00 Sub Total: $770,720.00 PROJECT 1 PROJECT ACCOUNT AMOUNT Carmel Street Department SHIPPING INSTRUCTIONS • SHIP REPAID. • GO.D. SHIPMENTS CANNOT BE ACCEPTED. • PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. • '• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 4 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. DOCUMENT CONTROL NO. 26296 ORDERED BY TITLE CLERK - TREASURER OFFICE COPY PAYMENT • AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY Wn1i•tI VOUCHER HAS THE • OPER SWORN AFFIDAVITATTACHEB. 11 I HEREBY CERTIFY HAT THERS-AS AN UNOBLIGATED BALANCE IN THIS APPROPRI • Jry'IC.- .ICIE TO PAY FOR T. ABOVE ORDER.