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ciit ®f CI1arrinie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAXXEXEMPT 100868
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
111212017 371648 Keyboard-Ellison
ARC ACQUISITION US INC Fire Department
VENDOR PO BOX 731576 SHIP 2 Civic Square
TO Carmel, IN 46032-
DALLAS,TX 75373--1576
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
20333
_ I
EQUANTITY + UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-632.01
1 Each Panasonic Premium Keyboard CF-VEK331 LMP $517.70 $517.70
Sub Total $517.70
Send Invoice To:
Fire Department
2 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
L DEPARTMENT ACCOUNT A PROJECT PROJECT ACCOUNTS AMOUNT
PAYMENT $517.70
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 ("\
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY - _ 1
Denise Snyder
TITLE Budget&Accreditation Manager
CONTROL NO. 100868 CLERK-TREASURER