24653 Ott 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
PURCHASE ORDER NUMBER
24653
THIS NUMBER MUST APPEAR ON INVOICES, AP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
1213/2014
y.--
Q:�t` r a-SS•C
VENDOR
Ott Equipment Service, Inc.
517 Herriman Court
Noblesville, IN 46060
SHIP
TO
Cannel Fire Department
2 Cannel Civic Square
Cannel, IN 46032
(317) 571-2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
N
y.--
QUANTITY I UN IT OF MEASUREI\
DESCRIPTION
UNIT PRICE
EXTENSION
NS
Account 43. 601.00
1 Each Labor to Install New Compressor - Sta. 41
Account 102 - 670.99
1 Each VR5-6 Champion Air Corn
Send Invoice To:
Cannel Fire Department
2 Cannel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$1,280.00
Sub Total:
$2,804.00
Sub Total:
$1,280.00
$1,280.00
$2,804.00
$2,804.00
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.
DOCUMENT CONTROL NO.
24653
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT $4 o4 00
• 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.
•