101870 FIRESTONE TIRE & SERVICE CENTER INDIANA RETAIL TAX EXEMPT Page 1 of 1
ciCity of iair]r1r1e1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101870
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
8/16/2018 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
28537
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-320.00
1 Each tires x 28 $4,206.08 $4,206.08
Sub Total $4,206.08
R4 Y Y a ' \
x'''
5 St
l '.. ,
L t
as€
Send Invoice To: ' ; _ �,7 A vs ....
4
Carmel Police Department _
Accounts Payable 's, '..z
� ,
3 Civic Square ,%
Carmel, IN 46032- ° '`
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $4,206.08
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 4 iCrw....- t
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Jim Barlow
TITLE Chief
CONTROL NO. 101870 CLERK-TREASURER