26213 R & T Tire and AutoCity of Carrnel
• ONE CIVIC SQUARE
CARMEL, INDIANA 46632 -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
26213
THIS. NUMBER MUST APPEAR ON INVOICES. NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
7125/2012
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
R &T Tire and Auto
• VENDOR
17016 Clover Road
Noblosallle, IN 46060
SHIP
TO
Carmel. Police Department
3 Civic Square
Cannel, IN 46032
(317) 671.2554
CONFIHMATICN
BLANKET
CONTRACT
PAYMENT TEAMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 42-320.00
40 Each tires
8 Each tires
Send Invoice To:
Carmel Pollen Department
Attn: Teresa Anderson •
3 Clalc Square
Cannel, IN 46032-
PLEASE INVOICE IN DUPLICATE'
165.00
$12132
Sub Total;
$2,600.00
$873.76
$3,573.76
if DEPARTMENT
ACCOUNT '
PROJECT
1 PROJECT ACCOUNT
Cannel Police Dept.
auti
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 INS
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 26213
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
• 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_
• I HERESY CERTIFYJ,I-lAT THERE IS AN JNCBLIGATED BALANCE IN
THIS APPROPHlA TTO FICIENT TO PAY FOR THE ABOVE, ORDER.
AMOUNT
$3,573.76
of of Pollco