24649 Hoosier Fire EquipmentCi
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 C `\ \
PURCHASE ORDER NUMBER
24649
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
1121/2014
-\
' \-----
-
—�� a_,-_,—.......-- c,,- Nv •
VENDOR
Hoosier Fire Equipment
4009 Montdale Park Drive
Valparaiso, IN 46383
SHIP
TO
Cannel Fire DepartmQt
2 Cannel Civic Square
Cannel, IN 46032
(317) 571 -2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
N
-\
' \-----
-
•
QUANTITY UNIT OF ME/SURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 102-670.
1 Each Eclipse LD Bullard bundle - TIC
1 Each Electrical Thermal Throttle
Send Invoice To:
Cannel Fire Department
2 Cannel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$7,055.00
$988.00
Sub Total:
$7.055.00
$988.00
$8,043.00
.�
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.
246 49
DOCUMENT CONTROL NO.
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT $8,043.00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE "ROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFYTHAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRI "SUE IGIENT TO PAY FOR E ABOVE ORDER.
1 d-