102023 WILLIAMS COMFORT AIR INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
Chit of IIriITIrIIe1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102023
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
10/19/2018 00350650
WILLIAMS COMFORT AIR INC Carmel Police Department
VENDOR 10773RD AVE.S.W. SHIP 3 Civic Square
TO Carmel,IN 46032-
CARMEL, IN 46032- Blaine Mallaber
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
30205
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-501.00
1 Each install wall mounted toilet $908.00 $908.00
Sub Total $908.00
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Send Invoice To: �_ tV
Carmel Police Department
Accounts Payable ° , New
3 Civic Square �,
Carmel,IN 46032- .
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT E PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $908.00
'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 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 r.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY 1�
Jim Barlow
/ �7
TITLE Chief
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CONTROL NO. 102023 CLERK-TREASURER ��