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City of CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100745
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 I VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 M
'PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
9/25/2017 364752 Helmets
FIRE SAFETY EDUCATION Fire Department
VENDOR 69185 SKYBROOK ROAD SHIP 2 Civic Square
TO Carmel, IN 46032-
MANDEVILLE, LA 70471 -
PURCHASE ID BLANKET CONTRACT I PAYMENT TERMS FREIGHT
19253
QUANTITY j UNIT OF MEASURE 1 DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 42-390.20
1 Each Discount ($1.00) ($1.00)
2900 Each Fire Helmets $0.69 $2,001.00
Sub Total $2,000.00
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Send Invoice To: ,, Mgr,F,�, X°°Y
Fire Department 4
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2 Civic Square `" - 4 ' /
Carmel, IN 46032- i ,, j +
PLEASE INVOICE IN DUPLICATE
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PROJECT - PROJECT ACCOUNT 1 AMOUNT
DEPARTMENT ACCOUNT _ ,
PAYMENT $2,000.00
*NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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 ' V
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY — --
Denise Snyder
TITLE Budget&Accreditation Manager
CONTROL NO. 100745 CLERK-TREASURER - r,