24407 Rogue Fitness INDIANA RETAIL TAX EXEMPT PAGE
City- of C acme l CERTIFICATE NO.003120155 002 0 PURCHASE ORDER MBER
FEDERAL EXCISE TAX EXEMPT
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
1112612012
Rogue Fitness Carmel Fire Department
VENDOR SHIP 2 Civic Square
TO
1080 Steelwood Road Carmel, IN 46032
Columbus, OH 43212 (317)571-2622
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UN F MEA DESCRIPTION UNIT PRICE EXTENSION
Account 102-6701.99
1 Each WPE Equipment- Per Attached Quote $17,614.85 $17,614.85
Sub Total: $17,814.85
. 'f
J� 1
Send Invoice To:
Carmel Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Fire Department PAYMENT 811414.85
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS TH .
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER AS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREB CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS A,• " SUFFICIEN '•PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C .SHIPMENTS CANNOT BE ACCEPTED. /� /. ,
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. C,
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
j"
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
24407 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY