101381 RUBBER DUCK DESIGN INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of Carmel003120155 002
CERTIFICATE
FEDERAL EXCISE TAX EXEMPTO PURCHA�S®OR1 �EQR�UMBER
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
2/7/2018 00352781
RUBBER DUCK DESIGNS Carmel Police Department
VENDOR 1 FRILEY CREEK ROAD SHIP 3 Civic Square
TO Carmel, IN 46032-
PETTIGREW,AR 72752- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
23245
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-301.00
1 Each Gold badge certificate seals $402.00 $402.00
Sub Total $402.00
Send Invoice To: . '. �
Carmel Police Department
Accounts Payable
3 Civic Square
Carmel,IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $402.00
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 C
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jeffrey Homer
TITLE Deputy Chief \\
CONTROL NO. 101381 CLERK-TREASURER N�