102123 ATLANTIC DIVING SUPPLY INC CityINDIANA RETAIL TAX EXEMPT Page 1 of 1
ofCannelCERTICATE NO.003120155 0020 PURCHASE ORDER NUMBERFEDERAL EXCISE TAX EXEMPT 102123
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
11/19/2018 372929 Helmets
ATLANTIC DIVING SUPPLY INC Fire Department
VENDOR 621 LYNNHAVEN PKWY SHIP 2 Civic Square
SUITE 160 TO Carmel,IN 46032-
VIRGINIA BEACH,VA 23452--7448
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31154
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-560.03
25 Each EOS-II-MPLS-BK Back EOS MPLS $45.99 $1,149.75
25 Each 82N-BL Exfil Sar BackCountry Helmet Blue-No Rails $143.86 $3,596.50
25 Each 80-SOL-1 Exfil Solas Reflective Kit $17.55 $438.75
1 Each Shipping $100.00 $100.00
Sub Total $5,285.00
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Send Invoice To:
Fire Department
2 Civic Square ��
Carmel, IN 46032- _
PLEASE INVOICE IN DUPLICATE
DEITI-MENH--- --1 ACCOUNT ! PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $5,285.00
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 -.-.„ :.
*T*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 \'' ,,,,,,,,,-..;,,,-~-> _-" ` "'''> n y''✓ 1-,c, —or C,_-_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY \\
Denise Snyder James Crider ^'�\l
TITLE Budget&Accreditation Manager Administration \V
CONTROL NO. 102123 CLERK-TREASURER