36646 Mid State Truck Equipment INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
1t O Carmel PURCHASE ORDER NUMBER
J FEDERAL EXCISE TAX EXEMPT 36646
35-60000972
t D[L:1,= =-,,- __- THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
2/13/2014 02/17/14 588 ao1,21a Snow-Ex salt spreader controller
Mid State Truck Equipment Inc. Parks Maintenance
11020 Allisonville Rd 1427 E. 116th Street ATTN: Courtney
VENDOR Fishers, IN 46038 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Snow-Ex salt spreader controller $409.95 $409.95
GLAccount# 1125413-4237000
Send Invoice To:
$409.95
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT l PROJECT I PROJECT ACCOUNT l AMOUNT
- PAYMENT
'• J • AIP 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
SHIPPING INSTRUCTIONS i FEB 2014 AFFIDAVIT ATTACHED.
EB 1 3 2014 . I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• C.O.D SHIPMENTS CANNOT BE ACCEPTED. I�`y
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LAKE . e.i•DERED BY Courtney SChlaegel � 1_K09,c x zl l�j(14,
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36646 VENDOR OP(