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CitCarmel®f CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100498
ONE CIVIC SQUARE L_ _ 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
CARMEL, INDIANA 46032 2584 SHIPPING LABELS AND ANY CORRESPONDENCE
1FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION j
6/8/2017 00352977
TYCO SIMPLEX GRIMMELL Street Department
;VENDOR DEPT CH 10320 SHIP 3400 W. 131st Street
TO Carmel, IN 46074-
PALATINE, IL 60055--0320 (317)733-2001
PURCHASE ID 1 BLANKET CONTRACT 1 PAYMENT TERMS FREIGHT
16090 1 1
QUANTITY r UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account: 43-501.00
1 Each Annual Service Agreement $1,451.18 $1,451.18
Sub Total $1,451.18
Send Invoice To:
Street Department
3400 W. 131st Street
Carmel, IN 46074-
(317)733-2001 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT 1 PROJECT ACCOUNT AMOUNT
PAYMENT $1,451.18
SHIPPING INSTRUCTIONS '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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /7, 04....x.1.
ORDERED BY . -- --. )-t"-'" �
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. —
Dave Huffman c _
TITLE Director \�(4l
CONTROL NO. 100498 CLERK-TREASURER