25499 Child Source 0 INDIANA RETAIL TAX EXEMPT PAGE
\\ //// \\
�� of Carmel CERTIFICATE NO.003120155 002 0
//// PURCHASE ORDER NUMBER
. FEDERAL EXCISE TAX EXEMPT 2541
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
p, 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
101012012
Child Souse Calm i Police Department
VENDOR SHIP 3 CIVIC Square
TO q
7001 Wooster F'lke Camel, IN 4
Medina, OH 442 (317)571 4550
CONFIRMATION .BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00 .05
1 Each shipping $58.80 $56.80
2 Each Voyager Highback 93-21 1FSM $29.90 $59.80
2 Each High Back Booster Front A4j '.3�I ' $47.20 $94.40
4 Each Titan 5 Carseat I 7 le! "/ $57.75 $231.00
4 . , T Sub Total: $442.00
'1 0. Wig`•
a
b
A. $R
611. .4 .i; '; ' I*
LS'
a
' 777
Send Invoice To:
Carmel Police Dopartmont
Attn: Teresa Anderson
3 Civic Squaw
Carlmoi, IN 46032= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. cC,,� PAYMENT $442.00
• 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 APPROPRIAT ON,SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. ••••■ .''''
•C.O:D.SHIPMENTS CANNOT BE ACCEPTED. !7/
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY -
Chid SHIPPING LABELS. bhl4ll ®!�1 Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 1'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25499 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY