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City c Carmel CERTIFICATE NO. 003120155 002 0
n \L/ w PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27933
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AP
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
9/28/2011
Intoximetors, Inc. Cannel Police Department
VENDOR SHIP 3 Civic Square
2081 Cralg Road TO Cannel, IN 48032
Bt. Louis, MO 83148 (317) 5712559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE, DESCRIPTION UNIT PRICE EXTENSION
Account 43.500.00
1 Each shipping charges $89.00 $89.00
1 Each repairs to iMoximeters $304.00 $304.00
1 Each repairs to Intoximeters $209.75 $209.75
0
-fi Sub Total: $802.75
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Send Invoice To: j
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT 1 AMOUNT
Carmel Police Dept. c\ L CS PAYMENT $602.75
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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION IENT TO 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. I�1 J of
Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER.
DOCUMENT CONTROL NO. 27933 OFFICE COPY