31988 Safelite Auto Glass City ty of f Carmel INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NOO.003120155 155 00 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 31988
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
5/2912014
Dafolite Auto Glass Cannel Police Department
VENDOR • SHIP 3 Civic Square
PO Box 633197 TO Cannel, IN 48032 .
Cincinnati, OH 45263-3197 1317)5712559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE] DESCRIPTION UNIT PRICE EXTENSION
Account 43-510.00
1 Each. Windshield replacement $278.50 $278.50
Sub Total: $278.50
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Car 74, Officer Zach Hasty 4 r d�
Send Invoice To: •�
Carmel Police Department
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Attn: Pat Young
3 Civic Square - _
Cannel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. , L(13 5276.50
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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT HERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATI FFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. lef of Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
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DOCUMENT CONTROL NO. 31988 CLERK-TREASURER
OFFICE COPY