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INDIANA RETAIL TAX EXEMPT PAGE
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CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27941
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
1018/2011
'Hubior Express Collision Carmel Police Department
VENDOR
SHIP 3 Civic Square
503 West Carmel Drive T Carmel, IN 48032
Carmel„ IN 48032 i (317) 5712559
CONRRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43410.00
1 Each repairs to vehide $988.55 $988.55
Sub Total: $988:55
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car 151 Dawson r u ®M GA Send Invoice To:
Carmel Pollee Department l »ll���
Attn: Teresa Anderson
3 Civic Square
Cannel, IN 48032 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. .-V PAYMENT $988.55
NP 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 P•0 ER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS H EREBY CERTIFY I HE RE IS AN UNOBLIGATED BALANCE IN
li THIS APPROPR v. FFICIENT TO OR THE ABOVE ORDER.
•SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. s of of Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1905 TITLE Y
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 7 9 4 1 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY