25519 Hubler Express Collision it"y I INDIANA RETAIL TAX EXEMPT PAGE
® f' CERTIFICATE NO.003120155 002 0
\��1/// 1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 299
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
11116/2092
•
Hublor Eupross Collision Camel Police Department
VENDOR SHIP 3 Civic aqua
TO
503 West Cia111901 1011vo Carr 18I, IN
Carmel„ IN 40032 (317)571=2
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS _ FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-610.00
1 Each repairs to vehicle $2,573.79 $2,573.79
Sub Total: $2,573.79
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Send Invoice To: -
Cannel Police Department �
Attn: Teresa Anderson
3 Civic Square
Canilel, IN 40032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept ()e.5 PAYMENT $2,573.79
• 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 CERTIFV'.JLATf'THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROP IATI•N FFICIENT 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. /let of Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 5 5 1.9 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY