26231 Child SourceCity 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
28231
THIS NUMBER MUST APPEAR ON INVOICES, AP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO
DESCRIPTION
511512012
Child Source
VENDOR
7001 Wooster Pike
Medina, OFt 44258
CONFIMIATION
BLANKET
CONTRACT
L..
PAYMENT TERMS
MI
A
•
-
• s - 1
V
QUANTITY UNIT OF MEASUREI
DESCRIPTION
UNIT PRICE
EXTENSION
Account 00a30,05
4 Each Voyager Highback
4 Each Trlan 5 Carseat
4 Each Safety 1st Designer Car Seat
1 Each shipping charges
Send Invoice To:
Cannel Pollee Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032-
93 -211 FSM
3702098
IC034P0B
PLEASE INVOICE IN DUPLICATE
$29.90
$57.75
$83.90
$125.90
Sub Total:
1119.80
$231.00
$255.60
$125.90
1732.10
DEPARTMENT
Cannel Police Dept.
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
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,
r�
DOCUMENT CONTROL NO. 26 31
ORDERED BY
TITLE
• CLERK - TREASURER
‘. OFFICECOPY
PAYMENT $732.10
• 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 HEREBY CERTIFY THAT THERE 15 AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION wSU FCIENT TO PAY FOR THE ABOVE ORDER,
hlef of Police