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102699 HOLLYWOODS BUMP AND GRIND INDIANA RETAIL TAX EXEMPT Page 1 of 1 I City of I1ariiie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 102699 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 3/4/2019 372102 HOLLYWOODS BUMP&GRIND Carmel Police Department VENDOR 10550 JESSUP BLVD SHIP 3 Civic Square TO Carmel, IN 46032- INDIANAPOLIS, IN 46280- Blaine Mallaber PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 34341 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1110 Fund: 101 General Fund Account: 43-510.00 1 Each vehicle repairs $1,483.00 $1,483.00 Sub Total $1,483.00 t f a Send Invoice To: .. f.i. 4. . �_�_.._ L..H . ;;: Carmel Police Department '``Tilson ` �Accounts Payable , 3 Civic Square 1 t 0 , , Carmel, IN 46032- - - , PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT R PROJECT 1 PROJECT ACCOUNT AMOUNT PAYMENT $1,483.00 •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. t '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 Jim Barlow \k TITLE Chief CONTROL NO. 1 02699 CLERK-TREASURER