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PURCHASE ORDER NUMBER •
FEDERAL EXCISE TAX EXEMPT - 37182
35-60000972
- . E:.:• -: -: THIS NUMBER MUST APPEAR ON INVOICES,NP
VOUCHER,DELIVERY MEMO,PACKING SLIPS.
SHIPPING LABELS AND ANY CORRE.SPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PuRci IASP ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/13/2014 06/15/14 1897 Wilfog Pavilion Ace-Pac supply order
Ace-Pak Products Inc. MCC -West
12602 Double Eagle Drive 1235 Central Park Drive East
SHIP
VENDOR Carmel, IN 46033 Carmel, IN 46032
TO
CONFIRMAI ION BLANKET CON FRAC F [LAYMEN F TERMS FREIGI IT
QUANTITY UNIT OF MEASURE] DESCRIPTION
i UNIT PRICE
I EXTENSION
2.000 case 15604349 56 gal. black trash $ 17.99 $ 35.98
1.000 case 15704348 56 gal. clear.trash $34.99 $ 34.99
2.000 case 60080343 facial tissue $21.49 $42.98
1.000 case 60082260 sanitary waxed didposable liners $ 17.99 $ 17.99
1.000 case 63000423 GoJo hand sanitizer $41.99 $41.99
1.000 each 63000721 drain maintainer $ 31.99 $31.99
1.000 each 630000504 urinal mats $43.95 $43.95
1.000 each 63000500 changing station liners $69.99 $69.99
GLACCOUnt[I 1125300-4238900
Send Invoice To:
$ 319.86
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
_I ACCOUNT
_I PFLOJEC I
I PROJECT ACCOUNT
1_ I1i
___....
H 25- L-1-13C 0 0 PAYMENT
• AIR 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.
. CO.!)SI fipmEniTs CANNO I.BE ACCF PIED.
• PURCHASE ORDER NUMBER MUST APPEAFL ON ALI SHIPPING LABELS. ORDERED BY Mike Kilpatrick
- v --
• THIS ORDER ISSUED IN COMPLIANCE MITI CHAP)ER 99,AC1 S 1945 I
AND ACTS AMENDATORY Fl ILREOF AND SUPPLEMEN F iiiiEREro.
TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 37182