HomeMy WebLinkAbout101699 HOLLYWOODS BUMP & GRIND ity
INDIANA RETAIL TAX EXEMPT Page 1 of 1
I of Lair e1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101699
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELs:
S 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
6/1/2018 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
26319
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fun
$1,274.50
d: 101 General Fund
Account: 43-510.00
1 Each Auto Repairs $1,274.50
Sub Total $1,274.50
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Send Invoice To: .. .W ., .,
Carmel Police Department u Rodruguez-car 19
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Accounts Payable
3 Civic Square
Carmel, IN 46032= `'
PLEASE INVOICE IN DUPLICATE
I DEPARTMENT ACCOUNT Y PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $1,274.50
SHIPPING INSTRUCTIONS 'AQP 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
ORDERED BY
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'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ) v�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. {/Jl
Jim Barlow
TITLE Chief
CONTROL NO. 101699 CLERK-TREASURER WWW