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City of C r e CERTIFICATE NO.0031201X55 002 0 PURCHASE ORDER NUMBER
i FEDERAL EXCISE TAX EXEMPT 29917
35-60000972 _
ONE-CIVIC SQUARE
THIS NUMBER MUST APPEAR ON INVOICES,AP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO. PACKING SLIPS.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL.- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE! DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/11/13 1 M001023 Od 333g, Brake and Tire Repairs - P08
Car-X Maint
VENDOR i I-1-3 r'\e LA Sic - V iOJ SHIP I •,.1: i- 7f:--'97-z-:.--:
LaYrel , I N 4io032
TO JUN 1 1 2013
I
;Xi4,,,,,,10N I FLAN,(CCT CONTRACT! PAYMENT TERMS FREIGHT-- -- _
I
CIJANTITY UNIT OE MEASURE DESCRIPTION _ [ EXTENSION
... ...._.._ I UNIT PRICE
1 EA Labor and Material to Repair Brakes and Purchase $1,504.37 $1,504.37
New Tires for P08
Send Invoice To
$1,504.37
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
1125-4-13-4351000-Auto Repairs & Maintenance PAYMENT
• Alp VOUCHER CANNOT RE APPROV:D FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PHOPEH SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS IN UNOE'_ICiATED BALANCE IN
•SHIP REPAID. THIS APPROPRIATION SUFFICIENT IJ PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. John Gates - DK
• PURCHASE ORDER NUMBER MUSE APPEAR ON ALL ORDERED BY �,�,.� r,c 1 1
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
29917 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY