101288 EVERGREEN MOUNTAIN, LLC INDIANA RETAIL TAX EXEMPT Page 1 of 1
City ®f ci armedCO PURCHASEOR�ER
NUMBER
FEDERAL EXCISE TAX EXEMPT18
8
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 367119
EVERGREEN MOUNTAIN, LLC Police Department
VENDOR PO BOX 1169 SHIP 3 Civic Square
TO Carmel, IN 46032-
TAOS, NM 87571--1169
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22611
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 210 Continuing Education
Account: 43-570.00
1 Each Training $675.00 $675.00
Sub Total $675.00
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Send Invoice To: „ , .,,w
Police Department Dawson-Live fire shoot house instructor 5/2-5/4 in Mount Carroll, IL
3 Civic Square :t
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $675.00
SHIPPING INSTRUCTIONS 'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 �;{!'', �'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY C1�
Jim Barlow \ZJ
TITLE Chief \\.$
CONTROL NO. 101288 CLERK-TREASURER