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26323 Carmel Clay Schools City ®� i/�(,� __ .•, I . 4 INDIANA RETAIL,TAX EXEMPT PURCHASE ORDER NUMBER of 1�/ J}11"�ljJ�11e I, �.RTI(=ICfANO.0031201550020 .. FEDERAL EXCISE TAX EXEMPT 26323 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P 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 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 12/18/2012 Carmel Clay Schools Street Department VENDOR SHIP 3400 W. 131st Street TO 5201 E. 131st Street Carmel, IN 46074 Carmel, IN 46033 (317) 733-2001 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 0042-313.00 1 Each diesel $29,427.00 $29,427.00 Sub Total: $29,427.00,,,,,,...iwn .,,,4,,, ©•, , '' ' .2 ° ��04 6 °° * * i 2 , , (b.) "' G 00 r itaik: -... 1 n 4 . is 1 . , ,,,, , 7,,,k, ,. ... 4.„ , ,:„,,, ,,, ...cf:Is Noi1/4\\T2 ''.. ''''''-''`.---.-`_, " .'''.4' Send Inv i T : � � �' - 0 z ce ° o o Street Department 3400 W. 131st Street . Carmel, IN 46074- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Street Department PAYMENT $29,427.00 • A/P 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 •SHIP REPAID. - THIS APPROPRIATIO �SUFFIT TO PAY FOR THE ABOVE ORDER. •C.O:D.SHIPMENTS CANNOT BE ACCEPTED. •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �{ SHIPPING LABELS. 7 • •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE "Ns--AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. iii ��3 Z 3 CLERK-TREASURER _DOCUMENT CONTROL NO. OFFICE COPY