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it'y C \\o f C sane l CERTIFICATE NO.003120155 002 0//// PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 24.409
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
11127/2012 ��.s. ,,,,,,sk . .
Stryker Medical Carmel Fire Department
SHIP 2 Civic Square
VENDOR TO
P.O. Box 93308 Carmel, IN 46032
Chicago, IL 60673 (317)571-2622
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY OF MEA E DESCRIPTION UNIT PRICE EXTENSION
Account 102-670.06
2 Each Stair Chair-- Per Attached Quote $2,:383.00 $4,786.00
Sub Total: $4,786.00 fry, .... ....4\„„
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Send Invoice To: �. ;�___ ..-
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Carmel Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Fire Department PAYMENT $4,756.00
• 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 PROPER SWORN AFFIDAVIT ATTACHED.
- SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT 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. \ �\
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE '1J� aq '� v
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 4 4 0 9 CLERK-TREASURER
DOCUMENT CONTROL.NO. VENDOR COPY