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cIityrof Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100832
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
10120/2017 361470
CHILD SOURCE Police Department
HIP 3 Civic Square
VENDOR 305 LAKE ROAD STO q
Carmel, IN 46032-
MEDINA,OH 44256-
PURCHASE ID I BLANKET I CONTRACT I PAYMENT TERMS FREIGHT
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20026 j
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE j EXTENSION
Department: 1110 Fund: 900 Grant Fund
Account: 43-590.05
4 Each 3431198 Chase no harness 40-110Ibs booster 2pk $26.95 $107.80
4 Each 3102198 Maestro 50 combo booster 20-100Ibs $58.30 $233.20
6 Each IC201CHZ OnBoard 35(4-35 lbs)with adjustable base and up front $84.00 $504.00
adjust
1 Each shipping charges $133.00 $133.00
2 Each 3472198 Sonus Convertible Seat 2PK. $57.75 $115.50
Sub Total $1,093.50
Send Invoice To:
Police Department
3 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $1,093.50
'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 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 Jf
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 tJ.a /7(r t.....¢/t-"'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY --- --
---\11)1144\ \*<
Jeffrey Homer \�
TITLE Deputy Chief
CONTROL NO. 100832 CLERK-TREASURER