36690 Omni Center INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0 City of C a rm PURCHASE ORDER NUMBER
(�� FEDERAL EXCISE TAX EXEMPT 36690
35-60000972
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
2/26/2014 03/03/14 702 00 504,5 (j Park Board Meeting Ch. 16 Rebroadcast
Omni Centre Administration Office
P.O. Box 302 1411 E. 116th Street
VENDOR Carmel, IN 46082-0302 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
27.000 each Prep & Rebroadcast of Park Board Meetings $300.00 $8,100.00
GLAccount# 1125101-4341999
Send Invoice To: •
$8,100.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
. 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.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper C (L ,Z,12_,(011 4-
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36690 :/ENDC.)13 CC)P".Y
•