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INDIANA RETAIL TAX EXEMPT Page 1 of 1
�I1. of Iarrriiie1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
/ FEDERAL EXCISE TAX EXEMPT 102118
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
',71V1 APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL—1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/16/2018 365283 Manikins
FIRE SERVICE INC Fire Department
VENDOR 9545 N INDUSTRIAL DR SHIP 2 Civic Square
TO Carmel, IN 46032-
ST JOHN, IN 46373-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31059
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: Fund:
Account:
Each
Sub Total
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
1 Each RT-21545165 Rescue Randy, 165 Pound $1,365.00 $1,365.00
1 Each RT-2395001050 Ruth Lee Manikin, 100 Pound $705.00 $705.00
1 Each Ruth Lee Manikin,44 Pound $465.00 $465.00
1 Each Shipping $350.00 $350.00
Sub Total $2,885.00
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Send Invoice To:
Fire Department
2 Civic Square %`'
Carmel, IN 46032- :
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $2,885.00
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 VOUCHER HAS THE PROPER SWORN
PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
0.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
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
` �
Denise Snyder \ \\
TITLE Budget&Accreditation Manager �`�
CONTROL NO. 102118 CLERK-TREASURER