26239 Hubler Express CollisionCif of C ui b el
ONE CIVIC SQUARE
CARMEL. INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 9997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
26239
THIS NUMBER MUST APPEAR ON INVOICES, WP
VOUCHER. DELIVERY MEMO. PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REOUISITION NO.
VENDOR NO
DESCRIPTION
012112012
Hublor Express Collision
VENDOR
503 West Cannel Drive )
Cannel„ IN 48032
SHIP
TO
Cannel Police Department
3 Chile Square
Carmel, IN 48032
{317) 571 -2559
CONFIPMATIDN
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
OUANTITY
UNIT OF MEASURE
DESCRIPTION
Account 43610.00
1 Each repairs to vehicle
1 Each repairs to vehicle
riii
Send Invoice ! 115 i Theis
UNIT PRICE
EXTENSION
Cannel Pollee Departmont
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032 -
DEPARTMENT
PLEASE INVOICE IN DUPLICATE
$541.68
$921.55
Sub Total:
3541.80
$921.55
$1,463.15
ACCOUNT
L63
PROJECT 1 PROJECT ACCOUNT.
AMOUNT
Carmel Police Dept.
•
- SHIP REPAID.
• 0.0.D, SHIPMENTS CANNOT BE ACCEPTED_
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1995
' AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
• DOCUMENT CONTROL NO. 262 3 9
SHIPPING INSTRUCTIONS
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT $1,483.15
• /VP VOUCHER CANNOT DE- 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 pp HERE IS AN UNODLIGATE❑ DALANCE IN
THIS APPROPRIATIOJbS'- Y"FICIENT TO PAY FORT E.aBOVE ORDER.
of or Police