51157 PFM CAR & TRUCK CARE INDIANA RETAIL TAX EXEMPT PAGE 1
{A CERTIFICATE N0.003120155 002 0tZity
C a 1PURCHASE ORDER NUMBER
•� 3, FEDERAL EXCISE TAX EXEMPT 51157
35-60000972
DNd WIC SQUARE
CARMEL,':IIMIA1I '4ion-2sE4 THIS NUMBER MUST APPEAR ON INVOICES,NP
- - - 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 04/14/18 15870 00352025 Replacement Tires for 2014 Ford Explorer-(Director's Vehicle)
PFM Car&Truck Care Parks Maintenance
1441 Guilford Rd., Suite 100 1427 E. 116th Street ATTN: Courtney
VENDOR Carmel, IN 46032 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
4.000 each Milestar MS932 Tires with install and disposal $ 124.0400 $496.16
1.000 each Four Wheel Alignment $79.9500 $79.95
GLAccount#1125401-4351000
Send Invoice To:
$576.11
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• MP 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
▪ C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE CLERK-TREASURER r�\421'
DOCUMENT CONTROL NO. 51157 VENDOR COPY !1�