25945 Public Safety Medical Services City ty f C sane l CERTIFICATE N IRTIFICA RENO. 003120 TAX 0 155 00 PAGE
l n l O. 155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25945
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO. PACKING SLIPS,
$HIPPING 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
12/2012011
Public Safety Medical Services Carmel Police Department
VENDOR SHIP 3 Civic Square
324 E. NOW York Street, Suite 300 TO Cannel, IN 48032
Indianapolis, IN 48204 (317) 571 -2559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE 1 DESCRIPTION UNIT PRICE EXTENSION
Account 43- 407.01
1 Each Offier Physicals $3,500.00 $3,500.00
Sub Total: $3,500.00
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Is- oQ o 4 4�
Send Invoice To: }��(`f
Cannel Police Department J/
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 1 AMOUNT
Cannel Police Dept. 1"-Liti PAYMENT $3,500.00
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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUF I I T TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. C of of Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO..
2 5 9 4 5 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY