101611 BGI FITNESS INDIANA RETAIL TAX EXEMPT Page 1 of 1
cilCity of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101611
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
412412018 362614 Treadmills
BGI FITNESS Fire Department
VENDOR 4340 EAST 82ND STREET SHIP 2 Civic Square
TO Carmel,IN 46032-
INDIANAPOLIS, IN 46250-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
25368
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
2 Each Matrix T3X Treadmill $3,799.00 $7,598.00
1 Each Precor Stretch Trainer $649.00 $649.00
1 Each Shipping Charges $400.00 $400.00
Sub Total $8,647.00
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Send Invoice To: .i....... Z.i..... ,.w...x .-'
Fire Department ,
2 Civic Square ', i'',''''''',-;'—"---"
Carmel, IN 46032- ' „ `X'
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT E PROJECT PROJECT ACCOUNT 1 AMOUNT
PAYMENT $8,647.00
`NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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 ,z^.,. .�0 —p
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 " ' ~ `' "et
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY `
Denise Snyder James Crider
TITLE Budget&Accreditation Manager Administration c�
CONTROL NO. 101611 CLERK-TREASURER