24570 Don Hinds Ford ® INDIANA RETAIL TAX EXEMPT PAGE ` v C
1 . \ ' ® Carmel CERTIFICATE NO.0031201 55 002 0
�/ �����//// PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 24570
35-60000972
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
311$114 �'-''
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.Don Hinds Ford Carmel Fire Department
VENDOR SHIP 2 Carmel Civic Square
TO
12610 Ford Drive Cannel, IN 46032
Fishers, IN 46038 (317)571-2622
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OI°MEASURE, DESCRIPTION UNIT PRICE EXTENSION
Account 102
1 Each 2014 Ford Utility Police Interceptor Base $26,753.00 $26,753.00
Sub Total: $25,753.00
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Send Invoice To: d r
Cannel Fire Department
•
2 Carmel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Cannel Fire Department PAYMENT V6,753.00
• 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;HE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • IHEREBYCERIFYYT�HATTHEREISANUNOBLIGATEDBALANCEIN
THIS APPROp.R T",ON UFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. / f
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. (f/
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY 7�
SHIPPING LABELS. / 1 , )
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /uY61//'1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY