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cii.City of Iairiiiinie1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101642
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
' SRM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
5/4/2018 372102
HOLLYWOODS BUMP&GRIND Carmel Police Department
VENDOR 10550 JESSUP BLVD SHIP 3 Civic Square .
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46280- .Blaine.Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
25665
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-510.00
1 Each Auto Repairs $1,310.60 $1,310.60
Sub Total $1,310.60
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Send Invoice To: tM
Carmel Police Department x
Accounts Payable
3 Civic Square - = °�v
Carmel, IN 46032- 4�
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $1,310.60
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
O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
- -- `JRCHASE 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 °N:41. 1
CONTROL NO. 101642 CLERK-TREASURER