101914 CXTEC INDIANA RETAILTAX EXEMPT Page 1 of 1'
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CCERTIFICATE NO. 120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101914
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 ��\
9/4/2018 366515
Bulkhead Adapter "�\
CXTEC ICS
VENDOR PO BOX 5211 SHIP 31 1st Avenue N.W.
DEPT 116003 . . TO Carmel, IN.46032-.
BINGHAMTON, NY 13902--5211 Timothy Renick (317)571-2576
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
29012 .
QUANTITY . UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1115 Fund: 101 General Fund
Account: 42-390.13
40- Each Bulkhead Adapters $13.97 $558.80
1 Each . . . freight : $21.36 $21.36
Sub Total $580.16
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Send Invoice To: 4 „' `14 R 1.j: wA .mow
ICSQuote No. 11055271
Timothy Renick ,
31 1st Avenue N.W. 11i - �. t „
Carmel,IN 46032- `.1-. : A .
(317)571-2576 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT-
PAYMENT $580.16
'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
`SHIP PREPAID. AFFIDAVIT ATTACHED.I.HEREBY CERTIFY THAT THERE IS AN UNOBUGATED 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 7
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Timothy Renick
TITLE Director
CONTROL NO. 101914 CLERK-TREASURER