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City of CL]r]rrie]I CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER 1
FEDERAL EXCISE TAX EXEMPT 102799l
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,MP
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
4/15/2019 00352042
DON HINDS FORD Carmel Police Department
VENDOR 12610 FORD DRIVE SHIP 3 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
35410
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-510.00
1 Each exhaust assembly $654.49 $654.49
1 Each headlight assembly $529.70 $529.70
Sub Total $1,184.19
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Send Invoice To: '� �.; �,,�� -t"�`., ,L_ . rrY !J'y}
Carmel Police Department �` ,�
Accounts Payable '�:� -
3 Civic Square - 7.- 4..•, ''
Carmel, IN 46032- ',- 4 d -
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT ! PROJECT PROJECT ACCOUNT 1 AMOUNT
PAYMENT $1,184.19
SHIPPING INSTRUCTIONS *Nip 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 LABE y� �
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 >� ��
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow
TITLE Chief
CONTROL NO. 102799 CLERK-TREASURER
