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INDIANA RETAIL TAX EXEMPT Page 1 of 1
CERTIFICATE NO.003120155 002 0 PURCH�SEoORDERUMBER
of Carme
FEDERAL EXCISE TAX EXEMPT 11223
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 r REQUISITION NO. VENDOR NO. DESCRIPTION
1/212018 372151
AGENCY360 Carmel Police Department
VENDOR 12175 VISIONARY WAY SHIP 3 Civic.Square
SUITE 104 TO Carmel, IN 46032-
FISHERS, IN 46038- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
— 22151
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department 1110 Fund: 101 General Fund
Account: 43-419.99
1 Each FTO training package $2,097.00 $2,097.00
Sub Total $2,097.00
a
Send Invoice To: {
Carmel Police Department "� a
Accounts Payable
3 Civic Square ..
K
Carmel, IN 46032-
,
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $2,097.00
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 V
'SHIP PREPAID. OUCHER 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 y� ,
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ' -� W
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY, N.
Jim Barlow
TITLE Chief \�—
CONTROL NO. 101223 CLERK-TREASURER '