51622 RENNER'S BODY WORKS INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
City
Io f `� r
i�L FEDERAL EXCISE TAX EXEMPT 51622
35-60000972
011E CMC SQUARE
C R!.`_I !NDIAIIA-501,2-2`S- THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
6/28/2018 07/02/18 16935 00351793 Body repair to vehicle#1172 2017 Toyata Tacoma
Renner's Body Works Parks Maintenance
8190 East 146th Street 1427 E. 116th Street ATTN: Courtney
VENDOR Noblesville, IN 46060 SOHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each Body repair to the front driver's side fender and door rearview $915.6800 $915.68
mirror per attached quote
GLAccount#1125401-4351000
Send Invoice To:
$915.68
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Courtney Weintraut
1S410
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
4\81"..\\
CLERK-TREASURER
4
DOCUMENT CONTROL NO. 51622 VENDOR COPY