32092 Child SourceCi
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
32092
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
7/712014
Child Source
Western Reserve Distributing, Inc.
VENDOR
305 Lake Rd
Medina, OH 44258
SHIP
TO
Cannel Police Department
3 Civic Square
Cannel, IN 48032
(317) 571-2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 0M90.05
1 Each shipping charges
4 Each Safety 1st on board 4 -351b
4 Each Backless Shieldless Booster
2 Each High Back Booster Front Adj
2 Each Chase No Harness Booster
4 Each Than 5 Carseat
quote 0 127879
Send Invoice To:
Carmel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 48032-
IC088BXT
93- 299FSM
PLEASE INVOICE IN DUPLICATE
$140.10
$84.00
$14.90
$47.20
$28.95
$57.75
Sub Total:
$140.10
$338.00
$59.80
$94.40
$53.90
$231.00
$915.00
DEPARTMENT
Cannel Police Dept.
ACCOUNT
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. 32092
PROJECT
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PROJECT ACCOUNT
PAYMENT
• 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.
HEREBY CERTIFY THAT/THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRI a • UFFICIENT TO PAY FOR THE ABOVE ORDER.
AMOUNT
$915 00
hlef of Police