102910 GRAND APPLIANCE & TV City (f /� INDIANA RETAIL TAX EXEMPT Page 1 of 1
o (( I1airinrie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
of
� FEDERAL EXCISE TAX EXEMPT 102910
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,ANP
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
5/30/2019 371994 TV-BC's Office
GRAND APPLIANCE AND TV Fire Department
VENDOR 10301 ENTERPRISE WAY SHIP 2 Civic Square
TO Carmel,IN 46032-
STURTEVANT,WI 53177-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
36587
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.07
1 Each 43UK6090-43"4k SmartTV $289.00 $289.00
Sub Total .$289.00
POW
5 qm
I
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT H ACCOUNT 9 PROJECT tl PROJECT ACCOUNT 9 AMOUNT
PAYMENT $289.00
SHIPPING INSTRUCTIONS *AIP 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 Accreditation Budget Administrator
CONTROL NO. 102910 CLERK-TREASURER