HomeMy WebLinkAbout102733 TYCO SIMPLEX GRIMMELL Jl INDIANA RETAIL TAX EXEMPT Page 1 of 1
City o Car}f'�'}� el CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102733
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
3/18/2019 00352977
TYCO SIMPLEX GRIMMELL Street Department
VENDOR DEPT CH 10320 SHIP 3400 W. 131st Street
TO Carmel, IN 46074-
PALATINE, IL 60055--0320 (317)733-2001
PURCHASE ID BLANKET I CONTRACT PAYMENT TERMS FREIGHT
34663 1
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 2201 Fund: 2201 Motor Vehicle Highway FND
Account: 43-509.00
1 Each Annual Service Agreement $1,653.70 $1,653.70
Sub Total $1,653.70
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Send Invoice To: 'k 5
Street Department I
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3400 W. 131st Street
Carmel, IN 46074-
(317)733-2001 _ PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT ! AMOUNT
PAYMENT $1,653.70
SHIPPING INSTRUCTIONS •AIP 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
T.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. i
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 �
AND AC AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY 2 (l
Dave Huffman
TITLE Director
CONTROL NO. 1 02733 CLERK-TREASURER