26104 TBA North C 0 INDIANA RETAIL TAX EXEMPT PAGE
y J t I'; 1\ arme l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
y �a 111111 FEDERAL EXCISE 00 0972 EXEMPT 28104r
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
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
312112012
TSA North Cannel Police Department
VENDOR THIP 3 Civic Squire
O
309 Cradle Drive Cannel, IN 482
Cannel, IN 48032 (317) 571 -2559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS t FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-315.00
2 Each 55 gallon drum $739.00 $1,478.00
Sub Total: $1,478.00
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Send Invoice To:
Cannel Police Department
Attn: Teresa Anderson
3 Civic Square
Cannel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT .PROJECT 1 PROJECT ACCOUNT AMOUNT
Cannel Police Dept. 1C3 PAYMENT $1,478•DQ
NP 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 S ORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBYCERTIFY E IS T AN UNOBLIGATED BALANCE INE
THIS APPROPRI N U IENi TO PAV FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL -t ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1905 TITLE lei' of
Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
q CLERK- TREASURER
DOCUMENT CONTROL NO.
26104 O4 OFFICE COPY