30323 Pearson Ford, Inc City o f Carmel_ e 1( INDIANA RETAIL FAX EXEMPT PARE
�(6�/ CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 30323
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER. DELIVERY MEMO. PACKING SLIPS,
CARMEL, INDIANA 46032 -2584 SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DAT DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12/27/11 M000640 231 51°0 Truck repairs to P01
Pearson Ford, Inc. Maintenance Ma)4R
10050 Nor+hM; aa� Rd SNIP nFr 2 7 2 117 1
VENDOR za On5VlLie) IQ 1 `r TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 EA Replace #1 and #6 coils, replace spark plugs, replace $621.31 $621.31
pcv hose, throttle body and egr port clean and adaptor
to intakes gaskets, replace fuel filter.
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Send Invoice To
$621.31
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
1125 -4 -01- 4351000 -Auto Repairs Maint PAYMENT
AR' VOUCHER CANNOT BE AFPROV1D FOR PAYMENT UNLESS THE P.
NUMBER IS MADE A FART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS IINOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT A PAY FOR THE ABOVE ORDER.
SHIP REPAID.
•C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY Todd Snyder DK N.; :K 3 /)-7 j
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. II`
30323 CLERK- TREASURER
DOCUMENT CONTROL NO. VENDOR COPY