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City I EXEMPT
INDIANA RETAIL M CERTIFICATE NO. TAX AX EXEXE P PT 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 2
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
6126/2013
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Child Source ":C �t t e•.tTremit •
SHIP . 3T^g R
VENDOR TO z3ezt. I . si i , ,
7001 Wooster Pike N 0 ri7 /� : ��.PlrZs
Medina, OH 442 Y 317).;51 .=�k„-�
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00452.00
1 Each shipping $928.50 $128.50
6 Each Pronto B/P H/B'Booster 22-491 FICA $29.90 $179140
2 Each Titan 5 Carseat 3�g $57.75 $995.50
6 Each High Back Booster Front ADJ f
g �-.f, � : :,. ������ $47.20 $283.20 ,
6 Each On Board 35 Infant Car Seat 68 o $77.40 $387.00
4
4 /4>ek ...... ,.<.. Sub Total: $1,093.90
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Send Invoice To: � ► --____- ,..-5 f pl
Carmel Police Dep r went
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 46032= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. PAYMENT $1,023.60
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
/ NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
• VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I CERTIFY THA THRE IS AN UNOBLIGATED BALANCE IN
THIS HEREBY APPROPRICERTATIO S T fFICIENT E TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID /
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. of•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE i' of E'o C$
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
2 5 3 4 9 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY