32251 Sunshine Medical SupplyCi
of Caramel
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
32251
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
12112/2014
Sunshine Medical Supply, Inc.
VENDOR
31575 Glendale Street
Livonia, MI 48150
SHIP
TO
Cannel Police Department
3 Civic Square
Cannel, IN 48032
(317) 571 -2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 42-390.12
1 Each latex gloves
■
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 48032-
PLEASE INVOICE IN DUPLICATE
Sub Total: - ';e- ®`o
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
r AMOUNT
Cannel Police Dept.
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. 32251
ORDERED BY
TITLE
CLERK - TREASURER
= OFFICE. 'COPY
PAYMENT $ 5L 1`1 *CO
• 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 THVIE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO. F. (CIENT TO PAY FOR THE ABOVE ORDER.
hlef of Police