25490 TBA North j INDIANA RETAIL TAX EXEMPT PAGE
C ®f. c CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
101212012
ThA North Cannel Police Department
VENDOR SHIP 3 Clule Square
TO
Gridle Drive Carmel, IN 46032
Carnal, IN 46032 (317)571
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY y ey'gpU�NIITTpOF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42.370.00.
1 Each 55 gallon drum $759.04 $759.84
Sub Total: $759.64
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477 <A. .\':**'.. ..**M- \1W
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Send Invoice To: "" r`5 -
..",.. ii°
UMW lei Pollee Department
Attn: Teresa Anderson
3 Chile Swam;
Carmel, IN 48032= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. PAYMENT $759.64
• 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.
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 --- nq/.luJ
SHIPPING LABELS. Chief �I 6�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE E+r'lel of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
CLERK-TREASURER
DOCUMENT CONTROL NON �/4 9®. OFFICE COPY