25474 Child SourceCi 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
25474
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
9/17/2012
Child Source
VENDOR
7001 Wooster Pike
Medina, OH 44258
SHIP
TO
Cannel Police Department
3 Civic Square
Carmel, IN 48032
(317) 571 -2559
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
OUANTITY
UNIT OF MEASURE 1
DESCRIPTION
UNIT PRICE
EXTENSION
Account 00490.05
2 Each Tribute 5 Convertible Car Seat
8 Each On Board35 Infant Car Seat
4 Each Baddess Shieldless Booster
1 Each shipping
Send Invoice To:
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032-
3812198
IC088FSM
99
PLEASE INVOICE IN DUPLICATE
ri
$48.95
$75.00
$14.90
$108.40
Sub Total:
$97.90
$450.00
$59.60
$108.40
$715.90
DEPARTMENT
Carmel 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.
DOCUMENT CONTROL NO. 25474
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT $715.90
• NP VOUCHER CANNOT PART OF THE 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 APPROPRIAT FFft )ENT TO PAY FOR THE ABOVE ORDER.
hlef of Police