HomeMy WebLinkAbout58410 MID STATE TRUCK EQUIPMENT INC INDIANA RETAIL TAX EXEMPT PAGE 1
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yar Ili 1 o CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
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FEDERAL EXCISE TAX EXEMPT 58410
35-60000972
ONE CIVIC SQUARE
C.ARMEL,IN DIAILIA 4E032.2 84 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
7/13/2023 07/17/23 32154 201250 Hitch Package with Installation for New Leased Ford F-150
Fleet Trucks(#2235,#2236,and#2237)
Mid State Truck Equipment Inc. Parks Maintenance
11020 Allisonville Rd 1427 E. 116th Street
VENDOR Fishers, IN 46038 SHIP Carmel, IN 46032
To
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
3.000 each 14021 Curt trailer hitch class IV 2" $ 395.000 $ 1,185.00
3.000 each 51120 Curt brake controller $ 99.000 $297.00
3.000 each TC1474P Connector dual 7way/4 way $26.000 $ 78.00
3.000 each Environmental & misc. shop supplies $ 55.000 $ 165.00
3.000 each Labor $ 625.000 $ 1,875.00
GLAccount# 1125401-4353099
Send Invoice To:
$ 3,600.00
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 AND SUPPLEMENT THERETO. TITLE Park Maintenance Foreman
CONTROLLER
DOCUMENT CONTROL NO. 58410 VII=::INIDO COPY