24661 Penn CareCi
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
a \\
PURCHASE ORDER NUMBER.
24661
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
92182014
y
�7 w G....-%-..—, - s.0cs- c z.—
VENDOR
Penn Care Inc.
1317 North Road
Niles, OH 44446
SHIP
TO
Cannel Fire Department n:
2 Cannel Civic Square •' ,
Cannel, IN 46032
(317) 571 -2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
y
QUA
QUANTITY I
WI OF MEASURE
Account 44. 650.03
DESCRIPTION
UNIT PRICE
1 Each 2014 Braun Chief XL on 2015 Ford F450
4x4 Chassis
Send Invoice To:
Cannel Fire Department
2 Cannel Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
e, ;•_-„c,
$199;877:00
EXTENSION
$199,677.00
Sub Total: $199,677.00
DEPARTMENT
Cannel Fire Department
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
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.
24661
DOCUMENT CONTROL NO.
PAYMENT $199.677.00
• 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 CEfjFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRI -TION GFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY