HomeMy WebLinkAbout101040 HOOSIER FIRE EQUIPMENT INC City ®f /f�7 � INDIANA RETAIL TAX EXEMPT Page 1 of 1
(� mel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
\ / FEDERAL EXCISE TAX EXEMPT 101 040
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
12/11/2017 131135 2.5"Fire Hose
HOOSIER FIRE EQUIPMENT INC Fire Department
VENDOR 4009 MONTDALE PARK DRIVE SHIP 2 Civic Square:
TO
Carmel IN 46032-
VALPARAISO, IN 46383-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21462
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
20 Each 8D17x50W15N 1.75"All Poly Double Jacket Rubber Lined $92.40 $1,848.00
20 Each 8D25x50W25N 2.5"All Poly Double Jacket Rubber Lined Hose $126.50 $2,530.00
20 Each 8D30x50W25N 3"All Poly Double Jacket Rubber Lined Hose $193.60 $3,872.00
Sub Total $8,250.00
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Send Invoice.To:
Fire Department
2 Civic Square
7ti; q
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $8,250.00
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 James Crider
TITLE Budget&Accreditation Manager Administration fk
CONTROL NO. 101040 CLERK-TREASURER