32208 Kustom SignalsChi
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
r,
;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
11 rem d
Kustom Signals
VENDOR
P.O. Box 411882
•
K�sac city, MO 8M41 -18A2
B
CONFIRMATION LANKET CONTRACT
SHIP
TO
PAYMENT TERMS
Cannel Police Department
3 Civic Square
Cannel, IN 48032
(117) 571 -2x,59
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43.800.00
1 Each radar repair
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
CAnnal IN 48012
DEPARTMENT
Cannel Police Dept.
$145.19
Sub Total:
PLEASE INVOICE IN DUPLICATE
$145.19
$145.19
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
r • 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. 32208
ORDERED BY
TITLE
PAYMENT $145.19 .
• 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 CERTIF TH4T THERE IS AN UNOBLIGATED BALANCE IN
THIS APPRO UFFICIENT TO PAY FOR THE ABOVE ORDER.
Chief of Police
CLERK - TREASURER
OFFICE COPY