101561 CHILD SOURCE Iair:irinie1INDIANA RETAIL TAX EXEMPT Page 1 of 1
Cityof CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101561
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL,INDIANA 46032-2584 1 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
•
4/9/2018 361470
CHILD SOURCE Police Department
VENDOR 305 LAKE ROAD SHIP 3 Civic Square
TO Carmel,IN 46032.
MEDINA,:OH 44256-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24848
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 900 Grant Fund
Account: 43-590.05
2 Each 3431198 Chase no harness 40-110Ibs booster 2pk $26.95 $53.90
2 Each 3102198 Maestro 50 combo booster 20-100Ibs $58.30 $116.60
3 Each IC201CHZ OnBoard 35(4-35 lbs)with adjustable base and up front $78.00 $234.00
adjust
1 Each shipping.charges $82.00 $82.00
2 Each 3472198 Sonus Convertible Seat 2PK. $57.75 $115.50
Sub Total $602.00
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Send Invoice To: , mF ,t,t
Police Department ."/
3 Civic Square " ° .
Carmel, IN 46032- ,,.
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $602.00
SHIPPING INSTRUCTIONS 'AIP 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 Va& n
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow
TITLE Chief
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CONTROL NO. 101561 CLERK-TREASURER