26215 Child Sourcecity df 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
26215
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
7/13/2012
o
1 1 Ificly a
FREIGHT
1
Child Source
VENDOR
7001 Wooster Pike
Medina, OH 44256
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
h\ •
1 1 Ificly a
FREIGHT
1
\1
QUANTITY 1 UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 00-580.05
1 Each shipping charges
4 Each Titan 5 Carseat
2 Each High Back Booster Front Adj
4 Each Safety 1st Designer Car Seat
Send Invoice To
Carnal Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 46032-
3702098
93- 209ESdv1
C034A08
PLEASE INVOICE IN DUPLICATE
$115.40
$57.75
$47.20
$83.90
Sub Total:
$115.40
$231.00
894.40
$255.80
$898.40
DEPARTMENT
Carmel Police Dept.
ACCOUNT
SHIPPING INSTRUCTIONS
PROJECT
• 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. 26215
ORDERED BY
TITLE
CLERK- TREASURER
OFFICE COPY
1 PROJECT ACCOUNT 1 AMOUNT
PAYMENT $6$8'40
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER 15 MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFjY THAT THERE 15 AN UNOBLICATED BALANCE IN
THIS APPROPji[g71ON SUFFICIE4T TO PAY FOR THE ABOVE ORDER.
Chief of Police