31997 Safelite Auto Glass C i ity c f Carmel CERTIFICATE ENO.003120155 M 020 PAGE
a- y �/ q.�JJ1LLL PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 - 31997
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
6/10/2014
Safelite Auto Glass Cannel Police Department
VENDOR TORIP re
3 Civic Squa
PO Box 633197 Cannel, IN 45032
Cincinnati, OH 452633197 (317)571-2559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43410.00
1 Each Wndshieid replacement - $290.89 $290.89
Sub Total: $290.89
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Carmel)Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. .\C55 PAYMENT $290.69
• 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 APPROP I 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
SHIPPING LABELS.'
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE NO of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
q CLERK-TREASURER
DOCUMENT CONTROL NO. 31997 OFFICE COPY