HomeMy WebLinkAbout102741 JORGENSON INDUSTRIAL COMPANIES ityr INDIANA RETAIL TAX EXEMPT Page 1 of 1
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0ERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102741
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
3/20/2019 373220 Lockers-CTC
JORGENSON INDUSTRIAL COMPANIES Fire Department
VENDOR 2895 SOUTH 300 WEST SHIP 2 Civic Square
TO Carmel, IN 46032-
SALT LAKE CITY, UT 84115-
PURCHASE ID 1 BLANKET CONTRACT PAYMENT TERMS FREIGHT
34779
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
3 Each Assembly $65.00 $195.00
1 Each Quote#SQ052620 $0.00 $0.00
1 Each Shiiping Charge $455.00 $455.00
3 Each Ventilated 2T, 15"W, 24" D, 36" H,78"TH 3W_,Visual Pelf, 6" $445.00 $1,335.00
Legs,Jet Black
Sub Total $1,985.00
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Send Invoice To: .,,
Fire Department
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2 Civic Square
Carmel, IN 46032- M
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,985.00
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. 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 NUM MUST APPEAR ON ALL SHIPPING LABEL
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'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 v\
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder
TITLE Budget&Accreditation Manager 1/41\i\4-
BER
CONTROL NO. 1 02741 •
CLERK-TREASURER