HomeMy WebLinkAbout28950 Car-X 6 INDIANA RETAIL TAX EXEMPT PAGE /J 1A$ of Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 28950
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AR
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
8 -31 -2011 M000556 00353385 Brakes repair replace on P0 M`
I
0 2 2011 I�
VENDOR SHIP L i
Car -X TO
I ►4 -a1sToNE U B L
CRRma N 1 49O32
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY ,UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
Brake repair /replacement on P01 incudes: 419.88 419.88
0004 Ford R50
Replacement brake pads on all four brakes
2 replacement roters on the front (work to resurface)
2 resurfaced back roters';'
PRICE INCLUDES AL•L LABOR_AND SUPPLIES
t f
TOTAL 419.88
IRI. I t r 114 rti
,1 f s t t
1.. F i I
l s
x'. I
1'
r s. r ('''.',,,,,',/7 e rr
Send Invoice To;
PLEASE INVOICE IN DUPLICATE
DEPARTMENT J ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
L A (350000 PAYMENT
1125 4-01 E ment maintenance AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
M p NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE 15 IN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. //,`��,j
C.O. D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY C` �chlaegel /R. Schmeising /M.Westermeier
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. I
1+118 ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
28950 CLERK- TREASURER I
DOCUMENT CONTROL NO. VENDOR COPY