32476 Child Sourceof 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
32476
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
9/26/2014
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
Child Source
Wester Reserve Distributing, Inc.
VENDOR Lake Rd
Medina, OH 44256
SHIP
TO
Carmel Police Department
3 Civic Square
Carmel, IN 48032
(317) 5712559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
Account 00-590.05
DESCRIPTION
UNIT PRICE
EXTENSION
1 Each shipping
8 Each Chase 14o Hamess Booster
6 Each High Back Booster Front Adj
8 Each Titan 5 Carseat 500
3 Each On Board35 Infant Car Seat
.Send Invoice To:
Carmel Police Department
Attn: Pat Young
3 Civic Square
Carmel, .114 46032-
3431198
93- 209FSM
3701498
1Tit1
IC068FSM
PLEASE INVOICE IN DUPLICATE
5298.50
526.95
547.20
• 557.75
$77.40
Sub Total:
5298.50
5215.60
5283.20
5462.00
5232.20
51 .491.50
ACCOUNT
PROJECT
PROJECT 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. 32476
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 PROPS SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY T RE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAj16NU CIENT TO PAY FOR THE ABOVE ORDER.
_ AOAMgyNT
hin9 of Police