101795 PWW MEDIA, INC. v INDIANA RETAIL TAX EXEMPT Page 1 of 1
IIit" o Iairinnie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101795
35-6000972
ONE CIVIC SQUARE 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
7/18/2018 372463 HIPPA Compliance Package
PWW MEDIA, INC. Fire Department
VENDOR 5010 E.TRINDLE ROAD SHIP 2 Civic Square
SUITE TO Carmel, IN 46032-
MECHANICSBURG, PA 17050-
C PURCHASE 16-1BLANKET CONTRACT PAYMENT TERMS FREIGHT
27665
L _QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-690.00
1 Each HIPPA Complete-Get the Guide and Training in One Package $500.00 $500.00
1 Each Shipping Charge $30.00 $30.00
Sub Total $530.00
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Send Invoice To: �` ,
Fire Department
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2 Civic Square �''
Carmel, IN 46032- L M�° , 3`--, ,,. �
_ PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $530.00
SHIPPING INSTRUCTIONS *AR 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.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 "'' -' ' ' -' "' "' �`"
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY
Denise Snyder A.
TITLE Budget&Accreditation Manager Y V�
CONTROL NO. 101795 CLERK-TREASURER