102241 DON HINDS FORD INDIANA RETAIL TAX EXEMPT Page 1 of 1
City
of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102241
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
12/6/2018 00352042 Repair A345
DON HINDS FORD Fire Department
VENDOR 12610 FORD DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31718
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-510.00
1 Each Repairs to A345 Per Quote $4,407.98 $4,407.98
Sub Total $4,407.98
tttt
� 1
S el
� y 7
Send Invoice To:
Fire Department
w.�
2 Civic Square
Carmel, IN 46032-
PLEASE
��. ...
INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $4,407.98
SHIPPING INSTRUCTIONS PART
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
CONTROL NO. 102241 CLERK-TREASURER