30468 Carmel Auto Refinishing Carmel C1a,/
INDIANA RETAIL TAX EXEMPT
PAGE
J CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Parks &Recreation FEDERAL EXCISE TAX EXEMPT 30468
35- 60000972
1411 E 116`^ Street THIS NUMBER MUST APPEAR ON INVOICES, NP
Carmel, IN 46032 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
02/15/2012 M000662 0C35014 Repair Hood from accident
Carmel Auto Refinishin Maint F)' 4 SH
VENDOR 30 5 Src Ala I� SHIP I� FEB 20 IC 11qq
III
Car met I N 4 D32 TO
BY:
COHRR TIDN BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 EA Repair Hood components plus clearcoat $631.20 $631.20
apoi FOR tD P\c■ CHEER
Send invoice To:
$631.20
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
1125-4-01-4350000-Equipment Repairs Maint PAYMENT
p AIP 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 SWORD AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS /N UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT I) PAY FOR THE ABOVE ORDER
•C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY D awn Koepper
PURCHASE ORDER NUMBER MUST APPEAR ON ALL I 0
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 30468 VENDOR COPY