25518 Hubler Express Collision C oity INDIANA RETAIL TAX EXEMPT PAGE
a.r e 1 CERTIFICATE NO.003120155 002 0
1i \��"/// li PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2559
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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
11/1612012 ,
bubisr Estpms Collision Carmel Police Department
VENDOR SHIP 3 Civic Squabs
TO
503 West Camel Drive Caimiol, IN
Camiei„ IN 46032 (317)5712550
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION • UNIT PRICE EXTENSION
Account 43-610.00
1 Each repairs to vehicle 5965.12 $065.12
Sub Total: $965.12
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Send Invoice To: I j-
Camel Police Department
Attn:Teresa Anderson
3 Civic Squaw
Camel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. PAYMENT $185.92
• 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 INE
THIS APPROPIG�N EFFICIENT 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. Chid•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Chid of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25518 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY