51974 BEST ONE OF INDY/INDY TIRE CENTERS, INC. Carniel INDIANA RETAIL TAX EXEMPT PAGE 1
SE ORDER NUMBERCERTIFICATE NO.003120155 002 0I( 4tFEDERAL EXCISE TAX EXEMPT 51974
35-60000972
011E CIVIC SQUARE
CARMEL,RI SEL,II'f34 f'li C32-25S= THIS NUMBER MUST APPEAR ON VOUCHER,DEUVE Y MEMO,PACKING S�P,
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
9/26/2018 09/30/18 17745 0035 (e{ Replacement Tires for Park Maintenance Truck and Trailer
Best One of Indy/Indy Tire Centers, Inc. Parks Maintenance
9302 E 30th Street 1427 E. 116th Street ATTN: Courtney
VENDOR Indianapolis, IN 46229 SHIP
HP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each M06-2014 Toyota Tacoma set of 4(P245/75R16) Firestone $642.0000 $642.00
Transforce HT Tires with install
1.000 each Flatbed Trailer set of 4(ST225/75R15)Carlisle 10ply Tires with $318.0000 $318.00
install
GLAccount#1125401-4351000
Send Invoice To:
$960.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT
• A/P 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 51974 VENDOR COPY