25476 G H S, IncCi 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
25476
THIS NUMBER MUST APPEAR ON INVOICES. NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
9/1712012
GHS, Inc.
VENDOR
8349 Nolth Washington Street
Sheridan, IN 46089
SHIP
TO
Carmel Police Department
3 Civic Square
Cannel, IN 46032
(317)571 -2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43.501.00
1 Each LED 2' Tamp
1 Each LED 4' lamps
1 Each convert 2x2 fixtures/Install 24' LED lamps
1 Each convert 2x4 light fixtures to LED la
Send Invoice To:
Carmel Police Department
Attn: Tensaa Anderson
3 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
$55.00
$61.75
$130.00
$1,835.00
Sub Total:
$55.00
$61.75
$130.00
$1,635.00
$1,881.75
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
Carmel Police Dept.
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C 0 D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALI.
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 25476
PAYMENT
$1,881.75
• NP VOUCHER CANNOT RE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED_
/(/ ✓J • I HEREBY CERTIFY THAT THERE I5 AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THO ABOVE ORDER.
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
Chief of Police