101545 DON HINDS FORD o INDIANA RETAIL TAX EXEMPT Page 1 of 1
111 iof Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101545
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
3/29/2018 00352042
DON HINDS FORD Carmel Police Department
VENDOR 12610 FORD DRIVE SHIP . 3 Civic Square
TO Carmel, IN 46032-
FISHERS,IN. 46038- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24636
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department:_ 1110 Fund: 101 General Fund
Account: 42-370.00
1 Each Taillight assembly $288.62 $288.62
Sub Total $288.62
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Carmel Police Department ,-
Accounts Payable
3 Civic Square ,. ,k,'„,,,,;, u, •
Carmel, IN 46032-
PLEASE
INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT 1 PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $288.62
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
Jim Barlow
TITLE Chief ,
CONTROL NO. 101545 CLERK-TREASURER V�