30725 Car X City f rLL LL e rt INDIANA RETAIL
T NO. FAX E 155 00 PAGE
1 i Ig�� CERTIFICATE NO. TAX EXEMPT PT 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 5 O 2 5—
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 swvawG LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
05/01/12 M000716 00353385 Tires, Oil Change Alignment
Car X n) l 'fN1> �f W
Maint d Ef P
VENDOR 143(-0 ry.LJyS:f /7/ 1 0 SHIP 1, MA" 0 1 ;)012
Car LiTLE,, 62 `}L032 To Luutj/
BY:
cONfwuwoN BLANKET CONTRACT PAYIMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
4 EA Goodyear Wrangler 255/70R16 Tires $125.00 $500.00
1 EA Mounting Disposal Fees $60.00 $60.00
1 EA Free Oil Change $0.00 $0.00
1 EA Free Alignment $0.00 $0.00
Send Invoice To:
$560.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
1125-4-02-4351000-Auto Repairs Maint PAYMENT
AT VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VDUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORD AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS /N UNOBUGATED BALANCE IN
THIS APPROPRIATION SUFFICIEIJTD PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY Mar Westermeier DK Liri,,L,,,XL,:-..jJp\ 13 llkl'L
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
CLERK TREASURER
DOCUMENT CONTROL NO. 30725 VENDOR COPY
I