101275 MUNICIPAL EMERGENCY SERVICES INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of iIIarinrie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101275
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
1/10/2018 358990 Gloves
MUNICIPAL EMERGENCY SERVICES Fire Department
VENDOR 75 REMITTANCE DRIVE SHIP 2 Civic Square
SUITE 3135 TO Carmel, IN 46032-
CHICAGO,IL 60675-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
22534
f QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-560.03
42 Each Gloves $68.00 $2,856.00
12 Each Gloves $70.00 $840.00
1 Each Shipping $15.00 $15.00
Sub Total $3,711.00
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Send Invoice To: Nts
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Fire Department
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2 Civic Square
Carmel, IN 46032- 4. �,,
PLEASE INVOICE IN DUPLICATE
L_ DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $3,711.00
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 '=` ' °
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyderle) ,.+0
TITLE Budget&Accreditation Manager
CONTROL NO. 101275 CLERK-TREASURER