HomeMy WebLinkAbout33237 Public Safety Medical Services01
of C.1r e1
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
35-60000972
PAGE
PURCHASE ORDER NUMBER
33237
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
11112/2015
Public Safety Medical Services
VENDOR
324 E. New York Street, Suite 300
Indianapolis, IN 46204
SHIP
TO
Carmel Police Department
3 Civic Square
Carmel, IN 46032
{317) 5712559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43-419.99
2 Each physical for applicant
Send Invoice To:
Carnal Police Department
Attn: Pat Young
3 Civic Square
Carmel, IN 4466032 -
PLEASE INVOICE IN DUPLICATE
$741.45
Sub Total:
$1,482.90
$1,482.90
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
Carmel Police Dept,
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. 33237
ORDERED BY
TITLE
CLERK -TREASURER
OFFICE COPY
PAYMENT
• NP 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 TAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRI[QIQSUFFICIENT TO PAY FOR THE ABOVE ORDER.
AMOUNT
$1,482.90
Net of Police