101283 GIBSON TELDATA INC City ®f IIarririe1INDIANA RETAIL TAX EXEMPT Page 1 1 _.....
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101 283
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1/12/2018 366241 Analog Terminal adapter
GIBSON TELDATA INC ICS
VENDOR :PO BOX 3000 SHIP 31 1st Avenue N.W.
TO. •
Carmel, IN 46032-
T
TERRE HAUTE,IN 47803- TimothyRenick
(317)571-2576
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22574
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1115 Fund: 101 General Fund
Account: 42-380.00
1 Each Analog.Terminal Adapter $169.00 $169.00
1 Each shipping $15.00 $15.00
Sub Total $184.00
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Send Invoice To:
ICS
Timothy Renick
31 1st Avenue N.W.
Carmel, IN 46032-
(317)571-2576
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $184.00
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 UNOBLIGATED BALANCE IN k
*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 y \
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
•
Timothy Renick
TITLE Director
CONTROL NO. 101283 CLERK-TREASURER