HomeMy WebLinkAbout33000 Child Source®f 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 0020
FEDERAL EXCISE TAX EXEMPT
35-60000972
PAGE
PURCHASE ORDER NUMBER
33000
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
7116/2015
Child Source
Western Reserve Distributing, Inc.
VENDOR
305 Lake Rd
Medina, OH 44258
SHIP
TO
Carmel Police Department
3 Civic Square
Cannel, IN 48032
(317) 571-2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
1
DESCRIPTION
UNIT PRICE
EXTENSION
Account 00-590.05
1 Each shipping charges
6 Each Chase FadorySeled Hamessed
Booster
8 Each Titan 5 Carseat
2 Each On Board35 Infant Car Seat
quote 0 0000142900
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 46032-
3062198
3702098
IC088ESIA
PLEASE INVOICE IN DUPLICATE
$125.50
$47.10
$57.75
$77.40
Sub Total:
$125.50
$282.60
$402.00
$154.80
$1,024.90
DEPARTMENT
Carmel Police Dept.
k.
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. 33000
PROJECT
ORDERED BY
TITLE
CLERK -TREASURER
OFFICE COPY
PROJECT ACCOUNT
AMOUNT
91,UL4.90
PAYMENT
• 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.
• I HEREBY CERTIFY THAT TNNGGpRE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATI•• .IJ fICIENT TO PAY FOR THE ABOVE ORDER.
of of Police