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INDIANA RETAIL TAX EXEMPT Page 1 of 1
CofCarmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100623 1
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
8/2/2017 367250 Lights for New Engines
DAT-A-SYST COMPUTER SERVICES Fire Department
VENDOR 377 RUBIN CENTER DR SHIP 2 Civic Square
TO Carmel, IN 46032-
FORT MILL,SM 29708-
BLANKET CONTRACT T PURCHASE ID ! 1 PAYMENT TERMS FREIGHT
i
17743 I
QUANTITY L UNIT OF MEASURE DESCRIPTION UNIT PRICE i
1 EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-510.00
1 Each Shipping $39.95 $39.95
2 Each XP4656C Bixenon Projector Kit with LED High Beams $1,195.00 $2,390.00
Sub Total $2,429.95
Send Invoice To:
Fire Department
2 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT r - PROJECT ACCOUNT q AMOUNT 1
PAYMENT $2,429.95
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 "' . `'.- i
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. Denise SnyderTITLE Budget&Accreditation Manager
CONTROL NO. 100623 CLERK-TREASURER