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o INDIANA RETAIL TAX EXEMPT Page 1 of 1
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CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100683
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
8/25/2017 022560
BATTERIES PLUS BULBS Information Systems
VENDOR P.O. BOX 302 SHIP 3 Civic Square
TO
Cannel,IN 46032-
NORTH MANCHESTER, IN 46962- Terry Crockett (317)571-2567
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
18453
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1202 Fund: 101 General Fund
Account: 42-302.00
6 Each SLA12-7F2 12V Lead batteries $19.95 $119.70
Sub Total $119.70
Send Invoice To:
Information Systems
Terry Crockett
3 Civic Square
Cannel,IN 46032-
(317)571-2567 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT _ PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $119.70
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 "_^x'47
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY UU —-`
Janet Arnone
TITLE Admin Assistant N •t(A
CONTROL NO. 100683 CLERK-TREASURER