101465 RITZ SAFETY INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101465
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
3/7/2018 366758
RITZ SAFETY Dept of Community Service
VENDOR 3330 N.SHADELAND AVE. SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46226--6257
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
23997
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 42-390.12
1 Each Safety Clothing $79.90 $79.90
Sub Total $79.90
a _ 5 �� ''''.
/ \,
:',q-
>4 t
,,
( IA, fi
r 1
{ i F +, � t
Send Invoice To: n `• f',.
Dept of Community Service3 �� � � �,_w
1 Civic Square
Carmel, IN 46032- '"°--,......, ,:i. a ,
yc a ...
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $79.90
SHIPPING INSTRUCTIONS *A/P 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 1
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 , G
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY a
Mike Hollibaugh
TITLE Director11.-;\, 11:
CONTROL NO. 1 01 465 CLERK-TREASURER 1`