105112 CHILD SOURCE
City of Carmel
EachEachEachEachEachEachSub Total
Department:Account:Fund:
44164334311983472198IC201CHZ3492198Chase no harness 40-110lbs booster 2pkSonus Convertible Seat 2PK.shippingOnBoard 35 (4-35 lbs) with adjustable base and up front Maestro Sport combination
booster (20-100lbs)Cosco Topside Backless Booster 1 pk$178.00$26.95$57.75$78.00$58.30$11.75Page 1 of 1$1,253.25$107.80$231.00$178.00$468.00$233.20$35.25
111043-590.05900Grant Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
adjust
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Police Department
105112
FEDERAL EXCISE TAX EXEMPT
35-6000972
3 Civic Square
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
Carmel, IN 46032-
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PLEASE INVOICE IN DUPLICATE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTIONDEPARTMENTACCOUNTPROJECTPROJECT
ACCOUNTAMOUNT
$1,253.25
PAYMENT
3/25/2021361470
* A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
CHILD SOURCE Trinity Clinic
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
305 LAKE ROAD 1045 W 146th St. Suite-B
*C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
TO
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
MEDINA, OH 44256 - Ann Gallagher
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Jim Barlow
TITLE
55037Chief
105112
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION