26199 Hubler Express Collisionr
CCi of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
28199
THIS NUMBER MUST APPEAR ON INVOICES. A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REOUIRED
REQUISITION NO.
VENDOR NO.
. DESCRIPTION
8/19/2012
Hublor Express Collision
VENDOR
503 Vilest Carmel Drive
Carmel„ IN 48032
SHIP
TO
Cannel Police Department
3 Civic Square
Cannel, IN 48032
(317) 571 -2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
OUANTITV
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43 -610.00
1 Each repairs to vehide
car 104 / Foster
Send Invoice To:
Cannel Police Department
Attn: Toresa Anderson
3 Civic Square
Cannel, IN 48032-
DEPARTMENT
Carmel Police Dept.
$444.80
Sub Total:
PLEASE INVOICE IN DUPLICATE .
ACCOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
A.
DOCUMENT CONTROL NO. 26199
$444.80
$444.80
PROJECT
1 PROJECT ACCOUNT
AMOUNT
$444.8U
PAYMENT •
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER 15 MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT THERE I5 AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY
TITLE \CCS
CLERK - TREASURER
OFFICE COPY
Chief of Police