32483 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
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
10114/2014
Child Source
VENDOR Western Reserve Distributing, Inc.
305 Lake Rd
Medina, OH 44258-
Cannel Police Department
SHIP 3 Civic Square
TO Cannel, IN 48032-
(317)571 -2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
3 Each On Board35 Infant Car Seat
2 Each Than 5 Carseat
1 Each Titan 5:,Carseat 5012
1 Each shipping
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Carmel, IN 48032-
IC088FSM
3702098
3701198
PLEASE INVOICE IN DUPLICATE
$77.40.
$57.75
$57.75
$82.35
$232.20
$115.50
$57.75
$82.35
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Cannel Police Dept.
x.05
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
ORDERED BY
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
E. .,,6 0
DOCUMENT CONTROL NO. 32483 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 PROPER S RN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT TER IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO}LSU 91 ENT TO PAY FOR THE ABOVE ORDER.