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Cit 37 of Carinniel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101043
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
12111/2017 00352717 SCBA Test Machine Maintenance
TSI INC Fire Department
VENDOR SDS 12-0764 SHIP :2 Civic Square
PO BOX 86 : TO Carmel,IN 46032-
MINNEAPOLIS, MN 55486--0764
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21479
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 .. Fund: 101 General Fund
Account: 43-509.00
1 Each Clean and Calibrate Model 8038 $995.00 $995.00
1 Each Clean Particle Generator $155.00 $155.00
1 Each Shipping $40.00 $40.00
Sub Total $1,190.00
••
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032: x
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $1,190.00
SHIPPING INSTRUCTIONS *AR VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
'SHIP PREPAID. PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
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 ~ ==`' = ' "` "' " ;a, ✓✓
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY �` AI
Denise Snyder
TITLE Budget&Accreditation Manager \ \
CONTROL NO. 101043 CLERK-TREASURER