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1111 of CERTIFICATE NO.003120155 002 0 \ ...N__ N
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 24503
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SUPS,
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
10/302013 \�.--.."...N�`. �-'�Qc
Municipal Emergency Services Cannel Fire Department
VENDOR SHIP 2 Civic Square
75 Remittance Drive, Suite 3135 TO Carmel, IN 46032
Chicago, IL 60675 (317)571-2622
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-660.03
1 Each Plug &Cribbing Bags $1,500.00 $1,500.00
Sub Total: $1,500.00
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Send Invoice To: arf�� �
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Cannel Fire Department
2 Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT • ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
Cannel Fire Department PAYMENT $1,500.00
• 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. I
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY S..." `-- Y• y/-
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL v
SHIPPING LABELS. \�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �pO�� °��
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. .J v
2+•t O 0 3 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY