25660 R & T Tire and Auto INDIANA RETAIL TAX EXEMPT PAGE Citof 1Ciriiie1 CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
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 -
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
3/412093
R 21 T Tire and Auto Cannel Police Department
VENDOR SHIP 3 Civic Square
TO
97099 Clover Road Car1if 911, IN 46032
Noblesville, IN 46060 (397)671-2659
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42. 20.00
40 Each tires $85.00 $2,600.00
Sub Total: $2,000.00
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Send Invoice To: ____fir ,
C wm l Police Department
Attn: Teresa Anderson .
3 Civic Square
Cannel, IN 42= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. Y5 PAYMENT $2,1 .00
• il-A/11P 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 THEW IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIO .6 (FI ENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY i "ii;
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE of of Pollee
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25660 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY