101314 SHAFTON INC ityT
INDIANA RETAIL TAX EXEMPT Page 1of 1
Cof Carmel PURCHASE ORDERN.NUMBER
NO.003120155 002 0 ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101314
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
1/23/2018 00352545 Replacement Sparky Costumue
SHAFTON INC Fire Department
VENDOR 6932 TUJUNGA AVE SHIP 2 Civic Square
TO Carmel, IN 46032-
NORTH HOLLYWOOD, CA 91605-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22850
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 42-390.20
1 Each Fan $155.00. $155.00
1 Each Shipping $88.40 $88.40
1 Each Sparky $1,345.00 $1,345.00
Sub Total $1,588.40
is
.,
Send Invoice To: 'x
Fire Department
2 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,588.40
SHIPPING INSTRUCTIONS •NP 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 ==r' ' "'' ' \\
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. \�
Denise Snyder �hV�=j
TITLE Budget&Accreditation Manager v\",
CONTROL NO. 101314 CLERK-TREASURER '�\