101678 CHILD SOURCE o INDIANA RETAIL TAX EXEMPT Page 9 of 1
Cit7 of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101678
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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 1
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION Us
5/23/2018 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
26153
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 852 Police Gift Fund
Account: 50-239.90
4 Each 93-299FSM backless shieldless booster(4 pack) $14.90 $59.60
6 Each 34311.98- . Chase no harnes 40-110Ibs booster 2pk $26.95 .$161.70
4 Each 3102198 Maestro 50 combo booster 20-100Ibs $58.30 $233.20
4 Each IC201CHZ OnBoard 35(4-35Ibs) $78.00 $312.00
1 Each shipping charges $95.00 $95.00
4 Each 34721.98 Sonus convertible seat 2pk $57.75 . $231.00
Sub Total $1,092.50
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Send Invoice To: - ` ` ..` '._
Police Department ,
11
3.Civic Square �'
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT V PROJECT ACCOUNT AMOUNT
PAYMENT $1,092.50
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 e'or"`farW
AND ACTS AMENDATORY THEREOF AND THERETO. ORDERED BY
.. .
Jim Barlow
TITLE Chief
CONTROL NO. 101678 CLERK-TREASURER