101285 TASK FORCE TIPS INDIANA RETAIL TAX EXEMPT Page 1 of 1
Cit C
of Carmel O - -PURCHASE - . -
FEDERAL EXCISE TAX EXEMPT10GARORDEQ�`
ORDER NUMBER
NUMBER
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
1/16/2018 361778 Repair Parts
TASK FORCE TIPS Fire Department
VENDOR 3701 INNOVATION WAY SHIP 2 Civic Square
TO Carmel, IN 46032-
VALPARAISO, IN 46383--9327
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22601
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department 1120 Fund: 101 General Fund
Account:.42-370.00
3 Each A1082-KIT Jumbo Biv Seal Kit $62.00 $186.00
1 Each Quote#427544 $0.00 $0.00
1 Each Shipping $9.73 $9.73
Sub Total $195.73
I-
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 $195.73
SHIPPING INSTRUCTIONS 'A/P 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 `� ,,,,,,,.-�%- • ^"z,'„'5'1,w” - ...V
ORDERED BY C
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
Denise Snyder
TITLE Budget&Accreditation Manager q
CONTROL NO. 101285 CLERK-TREASURER