32045 Bell TechlogixChi
of 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
3z c Lis
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
711 412 01 4
HDMI Adaptor
VENDOR
Bell Techiogix
PO Box 823342
Philadelphia, PA 18244242
SHIP
TO
Carmel Communications
3 Civic Square
Carmel, IN 46032-
(317)571 -2567
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE I
DESCRIPTION
UNIT PRICE
EXTENSION
5 Each Video /audoadapter F3W43AA
�c 2o/oC s4le,
Send Invoice To:
City of Carmel
3 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$19.43
$97.15
DEPARTMENT
ACCOUNT
PROJECT
1202 Carmel IS Dept. 42- 370.00
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• COO. 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. 32045
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PROJECT ACCOUNT AMOUNT
PAYMENT • $9715
• NP 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 THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.