102114 HOOSIER FIRE EQUIPMENT INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of IIariirie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102114
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
11/16/2018 131135
HOOSIER FIRE EQUIPMENT INC Fire Department
VENDOR 4009 MONTDALE PARK DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
VALPARAISO, IN 46383-
PURCHASE ID BLANKET I CONTRACT PAYMENT TERMS FREIGHT
31053
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
1 Each STF-2100 2100 Gallon Folding Frame Dump Tank $724.00 $724.00
1 Each 900-A 24'Aluminum 2-Section Ladder $582.00 $582.00
1 Each 1200-A 30'Aluminum 2-Section Ladder $814.00 $814.00
1 Each Shipping $408.07 $408.07
Sub Total $2,528.07
u g
Send Invoice To: '
Fire Department
2 Civic Square ff t
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT ' PROJECT ACCOUNT N AMOUNT
PAYMENT $2,528.07
SHIPPING INSTRUCTIONS 'A/P 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. 102114 CLERK-TREASURER