26202 Gibbs Auto Interiors` 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
26202
THIS NUMBER MUST APPEAR ON INVOICES. AP
VOUCHER, DELIVERY MEMO, PACKING SLIPS.
SHIPPING V+BELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO,
VENDOR NO.
_ DESCRIPTION
6/2512012
Ohba Auto Interiors
VENDOR
16316 US Highway 31 N
Westfield, IN 46074
SHIP
TO
Carmel Police Department
3 Civic Square
Cannel, IN 46032
(317) 5712559
CONFlPLIATION
BLANKET
CONTRACT
PAYMENT TERME
FREIGHT
OUANTITY
UNIT OF MEASURE I
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43.610.00
1 Each repair van seal
car 122 / Elliott
Send Invoice To:
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$125,00
Sub Total:
$125.00
$125.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
Cannel Police Dept.
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.
DOCUMENT CONTROL NO. 26202
• PAYMENT
• AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE RO_
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAI HERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT.• • FFICIENT TO PA FOR THE ABOVE ORDER.
ORDERED BY
TITLE
AMOUNT
$125.00
et of Police
CLERK- TREASURER
OFFICE COPY
•