101831 FIRESTONE TIRE & SERVICE CENTER INDIANA RETAIL TAX EXEMPT Page 1 of 1
(1ityof iairrinie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101831
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
8/1/2018 00351179
FIRESTONE TIRE&SERVICE CENTER Carmel Police Department
VENDOR PO BOX 403727 SHIP 3 Civic Square
TO Carmel, IN 46032-
ATLANTA,GA 30384--3727 Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
28029
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-320.00
1 Each tires $196.00 $196.00
Sub Total $196.00
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Send Invoice To:
Carmel Police Department : x �`
Accounts Payable
3 Civic Square
Carmel, IN 46032- ,.
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT J PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $196.00
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.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. 101831 CLERK-TREASURER