101712 EPR SYSTEMS USA, INC. (� INDIANA RETAIL TAX EXEMPT Page 1 of 1
1Io fir Carinnie1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
Jj JL FEDERAL EXCISE TAX EXEMPT 101712
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/6/2018 372468 NFIRS Analytical Reporting Tool
EPR SYSTEMS USA, INC. Fire Department
VENDOR 5020 CLARK ROAD#119 SHIP 2 Civic Square
TO Carmel, IN 46032-
SARASOTA, FL 34233-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
26509
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-632.02
1 Each NFIRS Analytics Reporting Tool $3,490.00 $3,490.00
Sub Total $3,490.00
. *441 :
1, 6 ,, ,
Send Invoice To:
..�. �_ . t. �„, �--- '-'-,.. ,4..,,,:::,, ---,.,
��.�m.: �
Fire Department
\., �,< I,
2 Civic Square a w \ ` r y'
i
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $3,490.00
SHIPPING INSTRUCTIONPART OF THE VOUCHER INSTRUCTIONS PART
NP VOUCHER CANNOT BE
AND APPROVEDEVERY FORINVOICE PAYMENTANDVOUCUNLESSHER THE P.O. NUMBER IS MADE A
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 y '" ''
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY {
Denise Snyder A
TITLE Budget&Accreditation Manager
CONTROL NO. 101712 CLERK-TREASURER