25482 Public Safety Medical Services ECity I INDIANA RETAIL TAX EXEMPT PAGE
c Carmel CERTIFICATE NO.003120155 002 0
�i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
W2012092
Public Safoty Modieal SIMI as Cool Polico Doparrtmont
VENDOR SHIP 3 Chile Square
TO
324 E: Now York Stroot, 8ulto 300 Carmel, IN 48032
Indianapolis, IN 48204 (397)579
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
•
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43407.01
1 Each physical for applicant $675.19 $675.19
Sub Total: $675.19
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N41/111K ..\ �•
407
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Send Invoice_Goss -40— N
UMW! Pollee Department
Attn: Ttan a2 Anderson
3 CIVIC Squaro
Cam1riG1, IN 46032= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
cannel Police Dept. PAYMENT $675.99
• NP 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.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE hiof of
PoIIci
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
248 2 • CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY