26195 Kustom Signals c 0 ®�1 /('�1./ INDIANA RETAIL TAX EXEMPT PAGE
11i CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35- 60000972 26195
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
611312012
Kustom Signals Carmel Police Department
VENDOR SHIP 3 Civic Square
P.O. Box 411882 TO Carmel, IN 46032
Kansas City, MO 64141 -1582 (317) 5712559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43600.00
1 Each repair to radar $588.00 $586.00
Sub Total: $588.00
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Send Invoice To: GM
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. PAYMENT 9.00
A/P 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 SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOB GATED BALANCE IN
THIS APPROPpI T N SUFFICIENT FOR THE ABOVE ORDER.
SHIP REPAID.
C 0 SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. hid of Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY