24579 Jim Coleman LTD City ty of f Carmel INDIANA RETAIL TAX EXEMPT 155 00 PAGE
N. 0�\
1nL CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
24579
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,MP
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
411412014 `.--14-\S � 154_��
Jim Coleman Ltd. Cannel Fire Department
VENDOR SHIP 2 Carmel Civic Square
TO
1500 South Hicks Road, Ste. 400 Cannel, IN 46032
Rolling Meadows, IL 60008 (317)5712622
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNITOT MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43450.02
170 Each Sport Bottles with Shipping $8.62 $1,125.25
Sub Total: $1,125.25
(ØMS
• ••,jf �� :
ria
illA,\,.Send Invoice To:
Pr
- I)
Carmel Fire Department
•
2 Cannel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Fire Department PAYMENT $1,125.25
• 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 HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY NN-- - -�����g-'�
SHIPPING LABELS
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE V-N-= �` `I
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V v\
2 4 5 7 9 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY -