101271 INTEGRITY FIRE PROTECTION, LLC INDIANA RETAIL TAX EXEMPT • Page 1 of 1
ciiit3T. of . IIIa:iriinie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER '
FEDERAL EXCISE TAX EXEMPT 101271
ONE CIVIC SQUARE : .:. 35-6000972 ... : THIS NUMBER MUST APPEAR ON INVOICES,AIP
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 .
1/10/2018 372005 Underground Flush& Backflow Repair=CTC -
INTEGRITY FIRE PROTECTION, LLC Fire Department
VENDOR 11722 ALLISONVILLE ROAD SHIP 2 Civic Square .
SUITE 103-317 . . TO:: Carmel,.IN:46032-
FISHERS, IN 46038-
- PURCHASE ID BLANKET CONTRACT
PAYMENT TERMS: ;.', FREIGHT;; .
22527 .
QUANTITY . UNIT OF MEASURE DESCRIPTION : : . UNIT PRICE . EXTENSION
Department 1120 Fund: 101 General Fund-
Account 43-501.00 • ..
1: Each
Repair Backflow: $560.00 $560.00
1 :Each ... . . Underground Flush - . . .. . . . : $490.00 ... $490.00.
Sub Total- $1,050.00
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Send Invoice To: _ -._`� "l`` i.
Fire Department-• .. . "
2 Civic Square. .
Carmel, IN 46032- "Al,'° �:1 1 �
PLEASE INVOICE IN DUPLICATE
DEPARTMENT :"i. ACCOUNT. :. 1 PROJECT 0 PROJECT ACCOUNT AMOUNT •
• PAYMENT $1,050.00
SHIPPING INSTRUCTIONS PART
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 UNOBUGATED.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 \ � -b'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder ' - \\c)1. .
I:. : TITLE : . .Budget&:Accreditation•Manager
CONTROL NO. :101271 CLERK-TREASURER