102130 BGI FITNESS City CarmelINDIANA RETAIL TAX EXEMPT Page 1 of 1
of CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102130
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
11/1912018 362614
BGI FITNESS Fire Department
VENDOR 4340 EAST 82ND STREET SHIP 2 Civic Square
TO
Carmel, IN 46032-
INDIANAPOLIS, IN 46250-
` PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31178
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
1 Each Lemond Revmaster Pro IC Bike $999.00 $999.00
1 Each Shipping $70.00 $70.00
Sub Total $1,069.00
IROF
4 t
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Send Invoice To: i
Fire Department 'z y:
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT E ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,069.00
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 \\<VC\ C.)
CONTROL NO. 102130 CLERK-TREASURER