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.