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Cit3I ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100515 ✓
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
6/21/2017 00352717
TSI INC , Carmel Police Department
VENDOR SDS 12-0764 SHIP 3 Civic Square
PO BOX 86 TO Carmel, IN 46032-
MINNEAPOLIS, MN 55486--0764 Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
16470
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-515.01
1 Each clean&calibrate fit test equipment $700.00 $700.00
Sub Total $700.00
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Send Invoice To:
Carmel Police Department *.'`''QUOTE#20101368"""
Accounts Payable
3 Civic Square •_ u„
Carmel, IN 46032- _-I ` 5
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $700.00 7
SHIPPING INSTRUCTIONS 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
'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 LABE �� !�
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 w vaa•` 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow NI
TITLE Chief
CONTROL NO. 100515 CLERK-TREASURER