37901 PFM Car & truckCity of Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PAGE 1
PURCHASE ORDER NUMBER
319D1
THIS NUMBER MUST APPEAR ON INVOICES, NI'
VOUCHER, DELIVERY MEMO. PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
12/8/2014
DATE REQUIRED
12/13/14
REQUISITION NO.
VENDOR NO.
DESCRIPTION
3683
Replace Tire on Director's Vehicle
PFM Car & Truck Care
1441 Guilford Rd., Suite 100
VENDOR Carmel, IN 46032
SHIP
TO
Parks Maintenance
1427 E. 116th Street ATTN: Courtney
Carmel, IN 46032
CONI-IRMA DON
ANKEI 1 CONTRACT 1 PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE I EXTENSION
1.000 each 2014 Ford Explorder Tire Replacement
GLAccount# 1125401- 4351000
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
$ 171.0200 $ 171.02
$ 171.02
DIFPAHIMLNT I ACCOUNT
PROJECT
PROJECT ACCOUNT
SHIPPING INSTRUCTIONS
SI HP REPAID.
COI) SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON AI I. SHIPPING IAREL S.
MIS ORDER ISSUED IN COMPLIANCE WIT H CI IAPTER 99, ACTS 191E
AND ACTS AMRNUA TORY THEREOF' AND SUPPLEMEN f THERE fO.
AMOUNT
PAYMENT
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.
ORDERED BY
TITLE
CLERK - TREASURER
DOCUMENT CONTROL NO. 3-`19171 VEN2OR COPY
Dawn Koepper
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