103005 DON HINDS FORD INDIANA RETAIL TAX EXEMPT Page 1 of 1
CIII City ®f Iiiriririe1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103005
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
7/17/2019 00352042
DON HINDS FORD Carmel Police Department
VENDOR 12610 FORD DRIVE SHIP 3 Civic Square
TO Carmel, IN 46032-
FISHERS, IN 46038- Blaine Mallaber
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
38053
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 42-370.00
1 Each steering gear $682.71 $682.71
Sub Total $682.71
d6 y,
Ss. Ft
Send Invoice To:
Carmel Police Department Car 68
Accounts Payable
3 Civic Square
Carmel, IN 46032-
_ PLEASE INVOICE IN DUPLICATE
L DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $682.71
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
*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 lad
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY u 1
Jim Barlow
TITLE Chief
N4C)
CONTROL NO. 1 03005 CLERK-TREASURER