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CERTIFICATE
FEDERAL EXCISE TAX EXEMPTO PURCHA1SE010 4ERFNUMBER
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR 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
311412018 353565
CROWN TROPHY Carmel Police Department
VENDOR 807 W CARMEL DRIVE SHIP 3 Civic Square
TO Carmel, IN 46032-
CARMEL, IN 46032- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24183
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-450.02
1 Each Employee awards $748.00 $748.00
Sub Total $748.00
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Send Invoice To: „ ��v,,, ,..,a, _
Carmel Police Department ��
Accounts Payable '`
3 Civic Square A e T �`
Carmel, IN 46032-
PLEASE INVOICE INE DUPLICATE
DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $748.00
SHIPPING INSTRUCTIONS 'AI
P 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 ��
Jim Barlow
TITLE Chief
CONTROL NO. 101495 CLERK-TREASURER