101232 R & T TIRE & AUTO - NOBLESVILLE ity
INDIANA RETAIL TAX EXEMPT Page 1 of 1
I of Carie PURCHASE -._.
CERTIFICATE NO.003120155 002 0 1 1 ORDER2 UMBER
FEDERAL EXCISE TAX EXEMPT ' I GJ
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
1/4/2018 00350983
R&T TIRE&AUTO-NOBLESVILLE Carmel Police Department
VENDOR 17016 CLOVER ROAD SHIP. 3 Civic Square
TO Carmel, IN, 46032-
NOBLESVILLE, IN 46060- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22237
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE. EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-320.00
1 Each tires $4,136.72 $4,136.72
Sub Total $4,136.72
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Send Invoice To:
Carmel Police Department ,r
Accounts Payable
3 Civic Square .
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $4,136.72
SHIPPING INSTRUCTIONS 'AIP 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
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 `
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY r \�j
Jim Barlow (/
TITLE Chief
CONTROL NO. 101232 CLERK-TREASURER ,e