HomeMy WebLinkAbout100803 MUNICIPAL EMERGENCY SERVICES Or INDIANA RETAIL TAX EXEMPT Page 1 of 1
Cit of Cnririiie1RTIFICTENO.0031201550020 PURCHASE ORDDER NUMBER
FEDERAL EXCISE TAX EXEMPT 1 00803
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
I
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1011312017 358990 Replacement Foam
MUNICIPAL EMERGENCY SERVICES Fire Department
VENDOR 75 REMITTANCE DRIVE SHIP 2 Civic Square
SUITE 3135 TO Carmel, IN 46032-
CHICAGO,IL 60675-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
19821
I QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
60 Each 443130-Ansulinte ARC(3%or 5%)AF-AFFF 5 Gal Pail Foam $78.05 $4,683.00
1 Each Shipping $225.00 $225.00
Sub Total $4,908.00
Send Invoice To:
Fire Department
2 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT I
PAYMENT $4,908.00
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
'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 \
CONTROL NO. 1 00803 CLERK-TREASURER _