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ity f t- arme I' CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27920
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
CARMEL, INDIANA 46032 -2584 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
9/1312011
Tie UniWorm Houso, Inc. Cafiligl Police Department
VENDOR
SHIP 3 Civic Square
9927 N. Capitol Avonue TO Caul ol, IN 48032
Indianapolis, IN 8202. (397) 579.25
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 Account 430.02
1 Each Polio Badge Design $2,700.00 52,70090
Sub Total: $2,700.00
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Send Invoice To.
Canna! Polka Dep mDnl
Attn: Teresa Anderson
3 Civic Square
Cannel, IN 4 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT $2,703.00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART. OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTI T AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROP I SUFFICIENT 'PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. V la? of Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO 27920 OFFICE COPY