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CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103027
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,ANP
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
7/23/2019 354912 Chair-Pattyn
R J E BUSINESS INTERIORS Fire Department
VENDOR 621 E OHIO ST SHIP 2 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46202-
PURCHASE ID i BLANKET CONTRACT PAYMENT TERMS FREIGHT
38286
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-630.00
1 Each 56985-Base Back Fabric Avanti-Base Iridescent Silver, $438.22 $438.22
Back-Gray Mesh
1 Each Install $60.00 $60.00
1 Each Proposal Number 19758 $0.00 $0.00
1 Each Shipping $95.00 $95.00
Sub Total $593.22
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Send Invoice To: '
Fire Department
2 Civic Square
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Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $593.22
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
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THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 r \
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY v
Denise Snyder
TITLE Accreditation Budget Administrator 4
CONTROL NO. 1 03027 CLERK-TREASURER