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ci .ltCity of IIariiie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102618
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
2/11/2019 079150 Helmets
DONLEY SAFETY Fire Department
VENDOR 5546 ELMWOOD AVE SHIP 2 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46203-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
33684
QUANTITY UNIT OF MEASURE DESCRIPTION • UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-560.03
7 Each Cairns 880 Helmet $254.00 $1,778.00
Sub Total $1,778.00
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Send invoice To:
Fire Department
2 Civic Square `
Carmel, IN 46032- 141,,
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,778.00
SHIPPING INSTRUCTIONS *A/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
Denise Snyder
TITLE Budget&Accreditation Manager
CONTROL NO. 102618 CLERK-TREASURER
