32433 Parkside Animal Hospitalchi
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
32433
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
9114/2014
Pathoide Animal Hospital
VENDOR
12982 Publishers Drive
Flatten), IN 48038
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 43.578.00
1 Each Spay surgery
J
K9 L.q Lo.- CLf lcer Vtegman
en nvolce a:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Carmel, IN 48032-
PLEASE INVOICE IN DUPLICATE
$300.00
Sub Total:
$300.00
$300.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
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.
•
DOCUMENT CONTROL NO. 324 33
ORDERED BY
TITLE
PAYMENT
• /MP 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 TH• flE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT W. . CIENT TO PAY FOR THE ABOVE ORDER.
$300.00 ,
of of Police
CLERK - TREASURER I -
OFFICE COPY