101976 FIRE SAFTEY EDUCATION INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of CInrinriie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101976
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
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
9/27/2018 364752 Helmets
FIRE SAFETY EDUCATION Fire Department
VENDOR 69185 SKYBROOK ROAD SHIP 2 Civic Square
TO Carmel, IN 46032-
MANDEVILLE, LA 70471 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
29640
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 42-390.20
5000 Each Fire Helmets $0.69 $3,450.00
Sub Total $3,450.00
$ 1 5
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Send Invoice.To:
Fire Department
2 Civic Square
m i q
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $3,450.00
SHIPPING INSTRUCTIONS 'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
'SHIP PREPAID. PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
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 z M.
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 = ' '' -• ' "� ` t•' 4V
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY - -- —�
Denise Snyder
TITLE Budget&Accreditation Manager
CONTROL NO. 101976 CLERK-TREASURER ___