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INDIANA RETAIL TAX EXEMPT Page 1 of 1
Iof IIIairiniie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101702
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SUPS,
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
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
26348
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-510.00
1 Each Auto Repairs $1,090.60 $1,090.60
Sub Total $1,090.60
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Send Invoice To:
Carmel Police Department 'car 68-Crayner
Accounts Payable ` `,
3 Civic Square
Carmel, IN 46032- -.,� �
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT A PROJECT PROJECT ACCOUNT b AMOUNT
PAYMENT $1,090.60
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
*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 �44Lb W
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow
TITLE Chief
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CONTROL NO. 101702 CLERK-TREASURER �/ \A