100549 DON HINDS FORD 1 .
City
INDIANA RETAIL TAX EXEMPT Page 1 of 1
��jjJj®� Carme� ! CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100549
ONE CIVIC SQUARE 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
7/10/2017 00352042
DON HINDS FORD Carmel Police Department
VENDOR 12610 FORD DRIVE SHIP 3 Civic Square
TO Carmel, IN 46032-
FISHERS,IN 46038- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT ! PAYMENT TERMS FREIGHT
16976
QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE 1 EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-370.00
1 Each steering gear $638.54 $638.54
Sub Total $638.54
Send Invoice To:
Carmel Police Department car 83
Accounts Payable
3 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $638.54
SHIPPING INSTRUCTIONS *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
'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 ALL SHIPPING LABEL i 4
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTERV 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY --- ---—
Jim Barlow
TITLE Chief
CONTROL NO. 1 00549 CLERK-TREASURER