101240 MUNICIPAL EMERGENCY SERVICES INDIANA RETAIL TAX EXEMPT Page 1 of 1
City ®f Carniie1 CERTIFICATE
003120155 002 0
PURCHASE
FEDERAL EXC ISTAX EXEMPTA101240 012 ORDER NUMBER
O
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
1/5/2018 358990 Facemasks for Personnel
MUNICIPAL EMERGENCY SERVICES Fire Department
VENDOR 75 REMITTANCE DRIVE SHIP 2 Civic Square
SUITE 3135 TO Carmel, IN 46032-
CHICAGO,IL 60675-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22313
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
10 Each 201215-29 Scott New AV3000HT 4 Point Kevlar-Rt Brkt-Large $280.00 $2,800.00
155 Each 201215-28 Scott New AV3000HT 4 Point Kevlar-Rt Brkt-Medium $280.00 $43,400.00
Sub Total $46,200.00
M ..
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $46,200.00
SHIPPING INSTRUCTIONS 'AlP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
'SHIP PREPAID. 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
*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
Denise Snyder James Crider
TITLE Budget&Accreditation Manager Administration
CONTROL NO. 101240 CLERK-TREASURER