101603 HARLEY DAVIDSONB INDIANA RETAIL TAX EXEMPT Page 1 of 1
ciCity ofIariinie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101603
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
4/2312018 354332
HARLEY DAVIDSON Carmel Police Department
VENDOR 12400 REYNOLDS DRIVE SHIP 3 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
25316
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-510.00
1 Each motorcycle repair $923.17 $923.17
Sub Total $923.17
tI_'
£ 1' S a
Send Invoice To: b, � ,.F
Carmel Police Department "°
Accounts Payable
3 Civic Square s "
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $923.17
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. 101603 CLERK-TREASURER