101305 CHILD SOURCE o INDIANA RETAIL TAX EXEMPT Page 1 of 1
CitCarmelofC O PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT1o5UM
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AR
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
1/19/2018 361470
CHILD SOURCE Police Department
VENDOR 305 LAKE ROAD SHIP 3 Civic Square
TO Carmel, IN..46032-
MEDINA,OH 44256-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22748
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 852 Police Gift Fund
Account: 50-239.90
3 Each IC201CHZ OnBoard 35(4-35Ibs) $78.00 $234.00
1 Each shipping charges $38.00 $38.00
Sub Total $272.00
Send Invoice To:
Police Department
3 Civic Square
Carmel, IN 46032- •
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $272.00
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 APPEARALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER70 99,ACTS 1945 7 _1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY \<lk\
Jim Barlow
TITLE Chief
CONTROL NO. 1013055 CLERK-TREASURER