102089 LION FIRST RESPONDER PPE INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
t11 .City of Iairiririe1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102089 _ _
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
11/9/2018 372923 Liquid Smoke
LION FIRST RESPONDER PPE INC Fire Department
VENDOR 7200 POE AVE SHIP 2 Civic Square
SUITE 400 TO Carmel, IN 46032-
DAYTON,OH 45414-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
30857
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 42-390.11
1 Each SLO5OG Liquid Smoke-50 Gallon Drum $1,995.00 $1,995.00
1 Each Shipping $275.00 $275.00
Sub Total $2,270.00
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Send Invoice To: ',, .1EAKi n . „z, 1m
Fire Department
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2 Civic Square —”'
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT 1 PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $2,270.00
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
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY "
Denise Snyder
TITLE Budget&Accreditation Manager
CONTROL NO. 102089 CLERK-TREASURER