102371 SHAFTON INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
III .it of Iarrrie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102371
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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 �
1211212018 00352545 Sparky Costume -1—
SHAFTON INC Fire Department
VENDOR 6932 TUJUNGA AVE SHIP 2 Civic Square
TO Carmel, IN 46032-
NORTH HOLLYWOOD,CA 91605-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
32143
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 42-390.20
1 Each Fan $175.00 $175.00
1 Each Shipping $63.79 $63.79
1 Each Sparky $1,345.00 - $1,345.00
Sub Total $1,583.79
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Send Invoice To: ....:. .-I-.',''':',77-1:-7,7'.:..,.�_, xr.
Fire Department
2 Civic Square' ','ii;i;i'"-1",:::,,,,,'''
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $1,583.79
'A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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 "...,2>j„„,„,,,,,„,,,,,..„,„_, .:M ':.. `"
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY
Denise Snyder
TITLE Budget&Accreditation Manager
CONTROL NO. 102371 CLERK-TREASURER