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INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
? ' 41 , i , ,, ,��� ,„,e, PURCHASE ORDER NUMBER
0111
FEDERAL EXCISE TAX EXEMPT 55051
35-60000972
ONE U WIU SQUARE
(CARMEL, IN 11A1,1A„„ O32-25,8,4 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
1/4/2021 01/03/21 24589 355214 Fleet Truck, Equipment Filters and Supplies
NAPA(Genuine Parts co.) Parks Maintenance
5959 Collections Center Drive 1427 E. 116th Street ATTN: Courtney
VENDOR Chicago, IL 60693 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each FIL 200697 (engine air filter truck 3174) $22.430 $22.43
1.000 each FIL 9883 (engine air truck 2181) $8.170 $ 8.17
GLAccount# 1125401-4232100 =30.60
2.000 each FIL 230266 (cabin air filter trucks 3174, 2181) $ 11.210 $22.42
6.000 each FIL 1064 (oil filter kubota rtvx's) $4.100 $24.60
4.000 each FIL 400043 (transmission rtvx 1100's) $ 10.210 $40.84
4.000 each FIL 400013 (transmission RTVX 1100's) $8.710 $ 34.84
2.000 each FIL 7616 (kubota tractor hst) $32.460 $ 64.92
2.000 each FIL 7098 (kubota tractor hydro) $ 17.130 $ 34.26
2.000 each FIL 1311 (oil filter kubota tractor) $2.890 $ 5.78
2.000 each FIL 3507 (fuel filter kubota tractor) $4.550 $ 9.10
2.000 each FIL 7730 (cat oil) $3.510 $ 7.02
GLAccount# 1125401-4351000 =243.78
Send Invoice To:
$274.38
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
▪ C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 55051
IF IN DO IR COPY