HomeMy WebLinkAbout103098 METHODIST SPORT MEDICINE INDIANA RETAIL TAX EXEMPT Page 1 of 1 I
City of �(\ JL armel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103098 ,
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,ANP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
9/4/2019 373555
METHODIST SPORTS MEDICINE Carmel Police Department
VENDOR 201 PENNSYLVANIA PKWY SHIP 3 Civic Square
SUITE 100 TO Carmel, IN 46032-
INDIANAPOLIS, IN 46280- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
39451
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-419:99
1 Each sports medicine&athletic training services for CPD $50,000.00 $50,000.00
Sub Total• $50,000.00
6 � Y
' 3
I_ $ 1..
E
I
R ,' y l i
Send Invoice To: ,
Carmel Police Department
Accounts Payable %
3 Civic Squares - , A
Carmel, IN 46032- '�
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $50,000.00
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. 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 i
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 (�-wQV�`
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow James Crider
TITLE Chief Administration (}�
CONTROL NO. 103098 CLERK-TREASURER \,