100394 BGI FITNESS TAIL TAX
PT
e 1 of
INDIANA
City of Carmel ,
CERTIFICATE
NO. Mg '
002 0 PURCHASEORDERNUMBER
FEDERAL EXCISE TAX EXEMPT 100394
ONE CIVIC SQUARE I 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO.PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
5/1/2017 362614 Treadmills-Sta.42/43
BGI FITNESS Fire Department
VENDOR 4340 EAST 82ND STREET SHIP 2 Civic Square
TO Cannel, IN 46032-
INDIANAPOLIS, IN 46250-
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PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
14964
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
2 Each Matrix T3X Treadmill $3,997.60 $7,995.20
Sub Total $7,995.20
Send Invoice To:
Fire Department
2 Civic Square
Cannel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT I
PAYMENT $7,995.20
SHIPPING INSTRUCTIONS
*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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL 1 _
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 (1-_____.--.- Th l \
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY -- -
Denise Snyder Douglas Haney
TITLE Budget&Accreditation Manager Corporation Counsel <0
CONTROL NO. 100394 CLERK-TREASURER S
1