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City of iI]rinr1e1HASEODERNBE.__
CERTIFICATEFEDERAL EXCISE TAX EXEMPTO PURCHA101216
SEoORD 1 UMBER
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MU''ST APP''EAARR ON INVOICES,AIP
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
1/2/2018 025950
BILL ESTES CHEVROLET Carmel Police Department
VENDOR 4105 W 96TH ST SHIP 3 Civic Square
TO - _
Carmel, IN 46032
INDIANAPOLIS, IN 46268- Blaine Mallaber
PURCHASE ID. BLANKET CONTRACT PAYMENT TERMS
FREIGHT.
22116
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-370.00
1 Each rear glass $499.80. $499.80
Sub Total $499.80
Send Invoice To:
a.
Carmel Police Department Car 135
Accounts Payable k . � "
3 Civic Square
Carmel, IN 46032- s f " `"
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $499.80
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
*con SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL ?zi� .�7 I•
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 � �=y" ��
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY �.
Jim Barlow \
TITLE Chief
CONTROL NO. 101216 CLERK-TREASURER