101304 DON HINDS FORD INDIANA RETAIL TAX EXEMPT Page 1 of 1Cityof Cariririel PURCHASEORDE NUMBER
NO.003120155 002 0 ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101304
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
1/19/2018 00352042
DON HINDS FORD Carmel Police Department
VENDOR 12610 FORD DRIVE SHIP 3 Civic Square
TO Carmel, IN 46032-
FISHERS,IN 46038- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22746
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-370.00
1 Each Taillight assembly $444.83 $444.83
Sub Total $444.83
N
Send Invoice To: •
Carmel Police Department
Accounts Payable
3 Civic Square
:
e�
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $444.83
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
Jim Barlow „tel
TITLE Chief
CONTROL NO. 101304 CLERK-TREASURER