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HomeMy WebLinkAbout25505 Public Safety Medical Services INDIANA RETAIL TAX EXEMPT \ //// 0. Jl PAGE O II Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER ■ FEDERAL EXCISE TAX EXEMPT 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P 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 10117/2012 . Public I a old Modica! Sorvlces ` Carand Polico DOPErtfliGlit VENDOR SHIP 3 Chile Squam TO 324 E. Now Vot1 l trrot, Suito M0 Car mol, IN 4032 Indianapolis, IN 46204 (317)571=2 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY �{t� �pUNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43407.01 2 Each physical for applicant $875.19 $1,350.38 Sub Total: $1,350.38 _ 0, © °• / r�� ° '• � Nook v 06 s .... ; , e ni . . \ .. t„ , , ,,„,, , Jonathan Rico/ChrisTcphor Bay H 9 -5, P Send Invoice To: 7 � Canino! Polies Dopamort .�� /� Attn: Toro Andorson 3 Chile &pun Catmol, IN 46032- PLEASE INVOICE IN DUPLICATE . DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. c)C.-5 PAYMENT $t350.': • 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 THERE1S AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUF ICIENT 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. Igo •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ChIof of I Polioio I AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO -! TH - ..2b 0 5 CLERK TREASURER DOCUMENT CONTROL NO. OFFICE COPY