102162 SARIS CYCLING GROUP INDIANA RETAIL TAX EXEMPT Page 1 Of 1
City
4. o f Carl CERTIFICATE NO.003120156 0020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102162 _
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL, INDIANA 46032-2584 VOUCHER;DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
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PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/28/2018 370534
SARIS CYCLING GROUP Dept of Community Service
VENDOR 5253 VERONA ROAD : SHIP 1 Civic Square
TO Carmel, IN 46032-
MADISON,WI 53711 -
PURCHASE ID BLANKET• CONTRACT PAYMENT TERMS FREIGHT
31362
QUANTITY . ::UNIT OF MEASURE : .: : .• - DESCRIPTION UNIT PRICE F : EXTENSION
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Department 1192 Fund: 101 General Fund
Account: 44-670:99 .
I Each : : : .:: Bike Equipment $2;650'.00 $2,650:00
• Sub Total $2,650:00
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Send Invoice To.-: -
Dept of:Comm'unity Service
1 Civic Square
ss
Carmel,:IN 46032-. . ...
PLEASE INVOICE IN DUPLICATE
DEPARTMENT: _ ACCOUNT _ . PROJECT " PROJECT ACCOUNT._' 1 AMOUNT
PAYMENT . - $2,650.00.
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
I. 'C.O.D.SHIPMENT CANNOT BE ACCEPTED. 7 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 l f� Q' - ��
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY - -- -
Mike Hollibaugh
. . TITLE Director-
CONTROL NO. 1 02162 CLERK-TREASURER