32271 Child SourceCity 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
32271
THIS NUMBER MUST APPEAR ON INVOICES, AIP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
12/18/2014
Child Source
VENDO"stem Reserve Distributing, Inc.
306 Lake Rd
Medina, OH 44268
SHIP
TO
Cannel Police Department
3 Civic Square
Cannel, IN 48032
(317) 5712559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 00590.05
1 Each shipping
4 Each Chase No Harness Booster
4 Each Than 5 Carseat
4 Each High Back Booster Front Adj
4 Each On Board35 Infant Car Seat
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 48032 -
3431198
3702098
93-209FSM
C068E:W4
PLEASE INVOICE IN DUPLICATE
$135.40
$28.95
$57.75
$47.20
$77.40
Sub Total:
$135.40
$107.80
$231.00
$188.80
$309.60
$972.80
DEPARTMENT
Cannel Police Dept.
ACCOUNT
PROJECT
PROJECT ACCOUNT I 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 APPROPRI ATIO IC NT TO PAY FOR THE ABOVE ORDER.
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. 32271
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
$972.60
Ch14f of Police