26051 Hubler Express Collision CI-4 '�y� 4 INDIANA RETAIL TAX EXEMPT PAGE
r 0 1\ arme I' CERTIFICATE NO. 003120155 002 0
a \L/ �a PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 28051
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO PACKING SUPS
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
112712012
Kibler Express Collision Carmel Police Department
VENDOR SHIP 3 Civic Square
503 West Cannel Drive TO Carmel, IN 48032
Carmel„ IN 48032 (317) 571-2559
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43410.00
1 Each repairs to vehicle $136.81 $136.61
Sub Total: $138.61
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Sen nvolce o: t
I Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Cannel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. c S PAYMENT $138.61
NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P 0.
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 T ER IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO F NT 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 Id of POIIco
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945 TITLE.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
26051 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY