101277 DONLEY SAFETY INDIANA RETAIL TAX EXEMPT I Page 1
City
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CERTIFICATE NO.003120155 002 0- PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 1 101277 •
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 - 079150 -
DONLEY SAFETY • Fire Department
VENDOR 5546 ELMWOOD AVE . : : SHIP 2 Civic Square
TO Carmel, IN.46032-:. : .. .
INDIANAPOLIS, IN 46203- -
PURCHASE ID BLANKET CONTRACT - - PAYMENT TERMS -FREIGHT
22540
:-QUANTITY : : UNIT OF MEASURE : DESCRIPTION UNIT PRICE EXTENSION
- Department 1120 Fund: 101 General Fund
. Account 43-560.03 .
: 6: Each C- 1010 Helmet Carmel $256.00 $1;536.00
TRD11221221A00
0 -- -3 Each - - Cairns 880 Helmet $228.22 $684.66
Sub Total : • $2;220.66
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Send Invoice To: 4-:, :sem a `' %�` t � � ,
Fire Department
2:Civic Square - - ..
•Carmel, IN 46032- 1-\'',,,;-„,,,,,,,,,,_PI p A
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I. .: :ACCOUNT.: . . PROJECT I PROJECT ACCOUNT .. .. . AMOUNT.
PAYMENT .. . .' . : : $2,220.66
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 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
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. , ORDERED BY
. . D ER ..
Denise Snyder
TITLE .. Budget&.Accreditation.Manager . .
CONTROL NO. =101277 CLERK-TREASURER