24692 Municipal Emergency ServicesCi
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
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PURCHASE ORDER NUMBER
24692
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.
FREIGHT
DESCRIPTION
2119/2015
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VENDOR
Municipal Emergency Services
75 Remittance Drive, Suite 3135
Chicago, IL 60675
SHIP
TO
Cannel Fire Department
2 Carmel Civic Square
Carmel, IN 46032
(317) 571 -2622
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MESU E•I.
DESCRIPTION
UNIT PRICE
EXTENSION.
Account 431.03
2 Each 3009 (4E) Boots
3 Each 4132 Boots
17 Each 5006 Boots
11 Each 3009 Boots
1 Each Shipping
Send Invoice To:
Carmel Fire Department
2 Cannel Civic Squire
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$535.00
$352.23
$379.47
$351.29
$20.00
Sub Total:
$1,070.00
$1,056.69
$6,450.99
$3,864.19
$20.00
$12,461.87
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Carmel 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. 24692
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
t'V' A61.87
• A/P 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 FOyTHE ABOVE ORDER.