HomeMy WebLinkAbout100510 HOOSIER FIRE EQUIPMENT INC u INDIANA RETAIL TAX EXEMPT Page 1 of 1
itUof cIIa.irirriie1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100510
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 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
6/16/2017 131135 Firehose
HOOSIER FIRE EQUIPMENT INC Fire Department
VENDOR 4009 MONTDALE PARK DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
VALPARAISO, IN 46383-
PURCHASE ID 1 BLANKET T CONTRACT T PAYMENT TERMS FREIGHT
16348
QUANTITY I UNIT OF MEASURE I DESCRIPTION UNIT PRICE 1 EXTENSION
Department: 1120 Fund: 10 Ambulance Capital Fund
Account: 44-670.99
10 Each ~,. 1 3/4"x 50' Ponn Conquest Double Jacked Hose with 1.5" $219.00 $2,190.00
NST Lightweight Coupling
10 Each 5'x 100' Ponn Conquest DJ hose with 5"Stortz Couplings $734.00 $7,340.00
Sub Total $9,530.00
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2 Civic Square /NC—
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Carmel, IN 46032- --
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT
l PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $9,530.00
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 UNOBUGATED 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 �'� '/
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY r�� �`^
Denise Snyder Douglas Haney �/ ,`
TITLE Budget&Accreditation Manager Corporation Counsel V iv\
CONTROL NO. 100510 CLERK-TREASURER le k