HomeMy WebLinkAbout106253 ROBERT MILLER & SON FURNITURE
City of Carmel
EachEachSub Total
Department:Account:Fund:
131LZB10-DeliveryLazyboy Recliners$200.00$425.00Page 1 of 1$5,525.00$5,725.00$200.00
112044-630.00102Ambulance Capital Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
709/D101279
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Fire Department
106253
FEDERAL EXCISE TAX EXEMPT
35-6000972
2 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
Recliners
$5,725.00
PAYMENT
2/2/2022375095
* 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
ROBERT MILLER & SON FURNITURE Fire Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
1540 E BLVD SUITE A 10701 N. College, Ste. A
*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 46280-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
KOKOMO, IN 46902 -
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Denise SnyderJames Crider
TITLE
63153Accreditation/Budget AdministratorDirector of Administration
106253
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION