101727 DON HINDS FORD INDIANA RETAIL TAX EXEMPT Page 1 of 1
Citof CIarinriie1 CERTIFICATE NO.003120155 0020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101727
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,ANP
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
6/13/2018 00352042 2018 Police Interceptor-C471
DON HINDS FORD Fire Department
VENDOR 12610 FORD DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
26653
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-650.01
1 Each 2018 Ford Police Interceptor Utility $25,962.00 $25,962.00
Sub Total $25,962.00
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Fire Department
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2 Civic Square \,, � yF °tom I�, „
Carmel, IN 46032- M
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT i PROJECT ACCOUNT AMOUNT
PAYMENT $25,962.00
SHIPPING INSTRUCTIONS 'A/P 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.RD �, ��
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL .. `/ 4`�' (-�/�l
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 �`'"1= '' '''- - ` ~� ."'� r)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY '�v
Denise Snyder James Crider
TITLE Budget&Accreditation Manager Administration
CONTROL NO. 101727 CLERK-TREASURER ,L