36578 PFM Car & Truck City (((``` Carmel INDIANA RETAIL TAX EXEMPT PAGE 1
/ ity o f Carmel CERTIFICATE NO.003120155 002 0
i`,/ PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 36578
35-60000972
. 1-4.1; _ 5 THIS NUMBER MUST APPEAR ON INVOICES,NP
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
1/27/2014 01/27/14 414 00361027 r vehicle estimate/repairs
PFM Car&Truck Care Parks Maintenance
1441 Guilford Rd., Suite 100 1427 E. 116th Street ATTN: Courtney
VENDOR Carmel, IN 46032 To P Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
•
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each M04- new tires LT 245/75R17 -set of 4 Safari ATR- see $723.60 $ 723.60
quote for details
1.000 each P06 brake repairs- see quote for details $ 1,076.39 $ 1,076.39
1.000 each P10 new tires P235/75R17 -4 new Wrangler SRA tires - See $ 620.80 $620.80
quote for details
GLAccount# 1125401-4351000
Send Invoice To:
$2,420.79
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• AIP 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.O.D SHIPMENTS CANNOT BE ACCEPTED. p/ , �/ /
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Courtney Schlaegel DeVutt �7 (�'L V / 12/7/i /
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 r LL
ANO ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36578 'i6NDOR COP'