52169 RENNER'S BODY WORKS INDIANA RETAIL TAX EXEMPT PAGE 1
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f � CERTIFICATE NO.003120155 002 0
t IQ • \ar el PURCHASE ORDER NUMBER
�� FEDERAL EXCISE TAX EXEMPT 52169 .
35-60000972
ONE CIVIC,:QUARE
D4i_I,4•I3I&_tIA 32-2q THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
11/28/2018 11/14/18 18139 00351793 Bumper replacement for TrUck 2181
Renners Body.Works Parks Maintenance
8190 East 146th Street 1427 E. 116th Street ATTN: Courtney
VENDOR Noblesville; IN 46060 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000. each Labor and material to replace bumper for truck 2181 $822.1400 $822.14
GLAccount#1125401-4351000
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Send Invoice To:
$822.14
PLEASE INVOICE IN DUPLICATE
DEPARTMENT • ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
▪ C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Courtney Weintraut
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 •
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 52169 VENDOR COPY