101741 JIM RUSSELL PLUMBING & HEATING INDIANA RETAIL TAX EXEMPT Page 1 of 1
City ®f IIaJr]r1r1Ie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101741
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
6/18/2018 356465
JIM RUSSELL PLUMBING&HEATING Carmel Police Department
VENDOR PO BOX 667 SHIP 3 Civic Square
TO Carmel, IN 46032-
ZIONSVILLE, IN 46077- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
26779
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-501.00
1 Each Installation of drinking fountain filters $817.00 $817.00
Sub Total $817.00
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Send Invoice To: : . tatt
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Carmel Police Department
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Accounts Payable , '
3 Civic Square
Carmel, IN 46032- t' r.
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT 1 PROJECT n PROJECT ACCOUNT AMOUNT
PAYMENT $817.00
'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 �_
'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. 101741 CLERK-TREASURER