HomeMy WebLinkAbout24743 BrighthouseCi
of 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 002 0
FEDERAL EXCISE TAX EXEMPT
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
1111612015
�i -,_, ""-S,.‘,
VENDOR
Brighthouse
P.O. Box 30262
Tampa, FL 3630-3262
SHIP
TO
Cannel Fire Department
2 Carmel Civic Square
Carmel, IN 46032-
(317) 571-2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
1 Each Drake EH24A Encoder Host Chassis
1 Each HDE24 Encoder Card
1 Each Labor
Send Invoice To:
Carmel Fire Department
2 Carmel Civic Square
Carmel, IN 46032 -
PLEASE INVOICE IN DUPLICATE
$1,320.00
$1,100.00
$240.00
$1,320.00
$1,100.00
$240.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Cannel Fire Dept. 00
42-370.00 PAYMENT g80
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS I
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY \ -Mynt ✓
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
-SHIPPING LABELS. 1
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMEr THERETO.
24743
DOCUMENT CONTROL NO.
CLERK -TREASURER
OFFICE COPY