24647 J & M Supplychi
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
THIS NUMBER MUST APPEAR ON INV
VOUCHER, DELIVERY MEMO, PACKIN
SHIPPING LABELS AND ANY CORRESPON
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
1112012014
'� �>„_ o • yr
VENDOR
J & M Supply
P.O. Box 1184
Cannel, IN 46032
SHIP
TO
Cannel Fire Department
2 Cannel Civic Square
Carmel, IN 46032
(317) 571 -2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY 4NIT 'or MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 4
40 Each Squeegee Fixed Head 28" White
Send Invoice To:
7088 -5
Cannel Fire Department
2 Cannel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$22.15
Sub Total:
$888.00
$888.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Carmel Fire Department
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
ENO ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
24647
)CUMENT CONTROL NO.
PAYMENT $88600
• 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.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY \�a��_
TITLE
CLERK - TREASURER
OFFICE COPY