32065 Kustom Signalstol Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
32(66
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
6/20/2094
Kustom Signals
VENDOR
P.O. Box 499992
Kansas City, MO 64949-1892
SHIP
TO
Carmel Police Department
3 Civic Square
Cannel, IN 46032
(397) 671-2669
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT ■
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 44-6770.
9 Each repair 4o radar
Send Invoice To:
Cannot Police. Department
Attn Pat Young
3 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$545.89
Sub Total:
$545.89
$545.89
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
Carmel Police Dept.
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 32065
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
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.
I HEREBY CERTIFY TH T HERE IS AN UNOBLIGATED BALANCE IN
THIS APPROP I• c iFFICIENT TO PAY FOR THE ABOVE ORDER.
AMOUNT
.89
of of Police
'11
,