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of11 ; CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
11 City Carmel
i FEDERAL EXCISE TAX EXEMPT 100592
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584VOUCHER,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
7/2012017 368049 Helmets
SENTINEL EMERGENCY SOLUTIONS Fire Department
VENDOR 23 GRANDVIEW PARK SHIP 2 Civic Square
TO Carmel, IN 46032- 1
ARNOLD, MO 63010-
t PURCHASE ID 1 BLANKET I CONTRACT T PAYMENT TERMS FREIGHT
17355
QUANTITY UNIT OF MEASURE t DESCRIPTION UNIT PRICE 1 EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-560.03
5 Each Helmets 880 Black $225.00 $1,125.00
1 Each Shipping $60.00 $60.00
Sub Total $1,185.00
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT �' — PROJECT PROJECT ACCOUNT AMOUNT 71
PAYMENT $1,185.00
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 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
N. s4f,)_.
`THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ' ..
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder /�,
TITLE Budget&Accreditation Manager v ‘1(1,
CONTROL NO. 100592 CLERK-TREASURER