24648 Municipal Emergency ServicesCi
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 _ q
PURCHASE ORDER NUMBER
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24648
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
112012014
Vim„
- -.
VENDOR
Municipal Emergency Services
75 Remittance Drive, Suite 3135
Chicago, IL 60675
SHIP
TO
Carmel Fire Department
2 Cannel Civic Square
Cannel, IN 46032
(317) 571 -2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
ti
Vim„
QUA
QUANTITY !UNIT OF MEASURE!
)
Account 43.560.0$
DESCRIPTION
UNIT PRICE
EXTENSION
13 Each ATAC 8" Station Plus
8 Each Pro Warrington 5006 Boots
Send Invoice To:
Cannel Fire Department
2 Cannel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$79.30
$379.47
Sub Total:
$1,030.90
$2,278.82
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DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Cannel 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
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
24648
DOCUMENT CONTROL NO.
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESV.tI_y
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 AAPPPRROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
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