HomeMy WebLinkAbout32238 Professional Psychological Servicesof Gemmel
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
I„ 35- 60000972
PAGE
•
PURCHASE ORDER NUMBER
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
1219/2014
i-
I
Professional Psychological Services
VENDOR
10293 North Meridian St, Suite 375
Indianapol s, IN 48290
1
SHIP
TO
Carmel Police Department
3 Civic Square
Carmel, IN 48032
(317) 5712559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43-419.99
4 Each Fitness for Duty Evaluation
eCnndidate T Tsting
Carmel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 48032-
PLEASE INVOICE IN DUPLICATE
$350.00
Sub Total:
$1,400.00
$1,400.00
DEPARTMENT
Carmel Police Dept.
ACCOUNT
PROJECT
PROJECT ACCOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER 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. 32238
PAYMENT
AMOUNT
$1,400.00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
I VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED..
1 • I HEREBY CERTIFY THATT ERE IS AN UNOBLIGATED BALANCE IN
• THIS APPROPRIAT /)I FICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY
(TITLE
CLERK - TREASURER
OFFICE.COPY