102158 MUNICIPAL EMERGENCY SERVICES INDIANA RETAIL TAX EXEMPT Page 1 of 1
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Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102158
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
11/27/2018 358990 Rope for EMS
MUNICIPAL EMERGENCY SERVICES Fire Department
VENDOR 75 REMITTANCE DRIVE i SHIP 2 Civic Square
SUITE 3135 TO Carmel, IN 46032-
CHICAGO, IL 60675-
PURCHASE ID ITLANKET CONTRACT PAYMENT TERMS FREIGHT
31297
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670:99
1 Each RQ-FFAX Seek Reveal Fire Pro $566.67 $566.67
1 Each Shipping $20.00 $20.00
Sub Total $586.67
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Send Invoice To: "
Fire Department
2 Civic Square ..
Carmel, IN 46032- �� �� ' _ _
PLEASE INVOICE IN DUPLICATE
r DEPARTMENT 1 ACCOUNT PROJECT I PROJECT ACCOUNT N AMOUNT
PAYMENT $586.67
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.SHiP6,ENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL c--
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 `� N
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY — ;i
Denise Snyder . \1
TITLE Budget&Accreditation Manager
CONTROL NO. 102158 CLERK-TREASURER