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City NO.003120155 002 0
t a r� e PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 38026
35-60000972
THIS NUMBER MUST APPEAR ON INVOICES.A/P
-- __ _<t .:.- ._ VOUCHER,DELIVERY MEMO.PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO VENDOR NO. DESCRIPTION
1/28/2015 01/25/15 3998 Inspect and Repair Brake Issues on P03 Chevy Silverado
Truck
PFM Car&Truck Care Parks Maintenance
1441 Guilford Rd., Suite 100 1427 E. 116th Street ATTN: Courtney
VENDOR Carmel, IN 46032 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT I PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE I DESCRIPTION 1 UNIT PRICE I EXTENSION
1.000 each Inspect& Repair Brakes on P03 Silverado Truck $ 1,706.1500 $ 1,706.15
1.000 each Remove& Replace Starter Assembly $ 371.7900 $ 371.79
GLAccount# 1125401-4351000
Send Invoice To:
$2,077.94
PLEASE INVOICE IN DUPLICATE
DEPARTMENI ACCOUNT PROJECT I PROJECT ACCOUNT ! AMOUNT
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER 15 MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SIHP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C .U SHIPMENTS CANNOT BE ACCEPTED- _
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper Phi, 1- .1�-�. l Z.��\`�
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 _ Y I
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 38026 VENDOR COPY