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HomeMy WebLinkAbout103082 CHILD SOURCE INDIANA RETAIL TAX EXEMPT Page 1 of 1 ci:City of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 103082 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 7/29/2019 361470 CHILD SOURCE Trinity Clinic VENDOR 305 LAKE ROAD SHIP 1045 W 146th St. Suite-B TO Carmel, IN 46032- MEDINA,OH 44256- Ann Gallagher PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 38368 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1110 Fund: 900 Grant Fund Account 43-590.05 4 Each 93-299FSM backless shieldless booster 4 pk $14.90 $59.60 6 Each 3431198 Chase no harness 40-110Ibs booster 2pk $26.95 $161.70 2 Each 3492198 Maestro Sport combination booster(20-100lbs) $58.30 $116.60 1 Each IC201CHZ OnBoard 35(4-35 Ibs)with adjustable base and up front $78.00 $78.00 adjust 1 Each shipping charges $109.00 $109.00 4 Each 3472198 Sonus Convertible Seat 2PK. $57.75 $231.00 Sub Total $755.90 w.. 111' -,:-.'.e._., . VLS 11 0. . \\11 - . f J 3• ,r d 11/41 Send Invoice To: '�Ar B „} ri \ _ Police Department 3 Civic Square Carmel, IN 46032- ' ASP* PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT PAYMENT $755.90 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 LABE *THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY Jim Barlow TITLE Chief � CONTROL NO. 103082 CLERK-TREASURER \��?