101767 LEACH & RUSSELL City
iIairirrie1 INDIANA RETAIL TAX EXEMPT Page 1 of 1
of CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101767
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
7/9/2018 362779 Sta.41 HVAC PM
LEACH&RUSSELL Fire Department
VENDOR 9151 FORD CIRCLE SHIP 2 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
27333
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-501.00
2 Each HVAC PM-Station 41 $750.00 $1,500.00
Sub Total $1,500.00
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Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $1,500.00
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 0.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 ~ =" -ate- '�"`` -✓
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. �
ORDERED BY
Denise Snyder
1\1TITLE Budget&Accreditanontion Manager
CONTROL NO. 1 01767 CLERK-TREASURER