26059 Kustom Signals City O f Carmel rme CERT
RETAiL TAX EXEMPT'
NO. 03120155 002 0 PAGE
y tau 111111 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 28059
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
2/3/2012
Kustom Signals Cannel Police Department
VENDOR SHIP 3 Civic Square
TO
P.O. Box 411682 Cannel, IN 46032
Kansas City, MO 64141-1882 (317) 571-2559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE( DESCRIPTION UNIT PRICE I EXTENSION
Account 43.600.00
1 Each repairs to antenna $248.03 $248.03
Sub Total: $248.03
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Send Invoice To: V -1 J 0,
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Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT p ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
Carmel Police Dept. ccilS PAYMENT $248.0
AN VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS HEREBY ATHAT�THERE I AN P THE D BALANCE IN
THIS APPRO AT FFICIENT TO PAY Y FOR FOR THE ABOVE VE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. hl8f of Pollee
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 6059 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY