26217 G H S Incof . 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
26217
THIS NUMBER MUST APPEAR ON INVOICES, AP
VOUCHER. DELIVERY MEMO. PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
[PURCHASE ORDER DATE
DATE REOUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
712512012
GHS, Inc.
VENDOR
8349 North Washington Street
Sheridan, IN 46089
SHIP
TO
Carnal Police Department
3 Civic Square
Cannel, IN 48032
(317) 5712559
CONFIRM/410N
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY I UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43501.00
4 Each convert 2x216duresfinstall 24° LED lamps
Estimate 01324
Send Invoice To:
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$158.75
Sub Total:
$827.00
$627.00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
Carmel Police Dept. •
• 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.
CS
SHIPPING INSTRUCTIONS
DOCUMENT CONTROL NO. 26217
. ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
• WP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER I5 MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THE; E IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO. -•FF,. ENT TO PAY FOR THE ABOVE ORDER.
AMOUNT
$27.00
lief of Police