32096 R&T TireCity 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
32096 •
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
7/2212014
D T llry and Auto
VENDOR
17018 Clover Road
Noblesville, IN 48080
SHIP
TO
Carmel 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 42420.00
20 Each Tires
20 Each Tires
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 46032-
P225 -80 R18
P235 -55 R17
PLEASE INVOICE IN DUPLICATE
$89.50
$108.92
Sub Total:
$1,790.00
$2,138.40
$3,928.40
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
Cannel 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.
. 'I,
DOCUMENT CONTROL NO. 32096
ORDERED BY
TITLE
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 PROP R SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THA ERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRI • . • F FICIENT TO PAY FOR THE ABOVE ORDER.
AMOUNT
$3,928.40
'lof of Pollee
n
CLERK - TREASURER
OFFICE COPY
•