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Home My WebLink About235054 07/22/14 (9, CITY OF CARMEL, INDIANA VENDOR: 356648 .......ONE CIVIC SQUARE ARAMARKCHECK AMOUNT: $ 877.22CARMEL, INDIANA 46032 22512 CHICAGO ILWORK PLACE CHECK NUMBER: 235054 CHECK DATE: 07/22/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4356001 15814044 877.22 UNIFORMS • BILLING INQUIRIES (800)504-0328 INVOICE NVOICE CUSTOMER SERVICE (800)785-2299 Uniform Services 2680 Palumbo Drive CUSTOMER NUMBER 18274861 Lexington, KY 40509 ACCOUNT NUMBER 1228033 Visit us at:www.ARAMARK-uniform.com TERMS NET 30 INVOICE NUMBER 15814044 INVOICE DATE 07/11/2014 SHIP VIA RPS/FedEx Ground PO# STREET DEPT STORE/LOC# SALES ORDER 806150571 -07/03/2014 CITY OF CARMEL IN 3400 W 131 ST ST PAGE 1 of 1 CARMEL IN 46074-8267 Ship To: STREET DEPT hLddlulln�lu�LlnllulnJ�611uluJJlul CITY OF CARMEL IN 3400 W 131 ST ST CARMEL IN 46074 ITEM ITEM DESCRIPTION WHS QTY LIST LIST TOTAL RICE SALE SALE TOTAL PRIC11132RYBLXL _ Poly Performance Ss Polo NV 30 27.99 839.70 !12.99 389.70 ll 132RYBL2XL Poly Performance Ss Polo- NV 10 . 31.99 319.90 12.99 129.90 6500 Custom Embroidery NV 49 3.51 171.99 3.51 171.99 11115RYBLL Wmns Polo Performance Ss Po NV 2 27.99 55.98 12.99 25.98 11115RYBLXL Wmns Polo Performance Ss Po NV 2 27.99 55.98 12.99 25.98 11132RYBL4XL Poly Performance Ss Polo NV 5 35.99 179.95 12.99 64.95 i SUBTOTAL 1,623.50 808.50 THANK YOU FOR YOUR BUSINESS SHIPPING AND HA ID G 68.72 6 TAX 6 6 61.65 F.O.B.Shipping Point TOTAL CHARGES CURRENT SHIPMENT $1,753.87 $938.87 • Thank you for your order, it is now complete. Form ST-105 Indiana Department of Revenue State Form 49065 R4/8-05 General Sales Tax Exemption Certificate Indiana registered retail merchants and businesses located outside Indiana may use this certificate.The claimed exemption must be allowed by Indiana code. Exemption statutes of other states are not valid for purchases from Indiana vendors.This exemption certificate can not be issued for the purchase of Utilities, Vehicles,WatercM ,or Aircraft, Purchaser must be registered with the Department of Revenue or the appropriate taxing authority of the purchaser's state of residence. Sales tax must be charged unless all information in each section is fully completed by the purchaser.Purchasers not able to provide all required information must pay the tax and may file a claim for refund(Form GA-110L)directly with the Department of Revenue. Name of Purchaser CITY OF CARMEL Business Address ONE CIVIC SQUARE City CARMEL State IN Zip 46032 a Purchaser must provide minimum of one ID number below.' Provide your Indiana Registered Retail Merchant's Certificate TID and LOC Number as shown on your Certificate............................... 0031201550 — 020 TID#(10 digits) LOC#(3 digits) If not registered with the Indiana DOR,provide your State Tax ID Number from another State................................................................ *See instructions on the reverse side if you do not have either number. state ID# State of Issue Is this a ®blanket purchase exemption request or a ❑single purchase exemption request? (check one) Description of items to be purchased. Purchaser must indicate the type of exemption being claimed for this purchase. (check one or explain) Cl Sales to a retailer,wholesaler,or manufacturer for resale only. ❑ Sale of manufacturing machinery,tools,and equipment to be used directly in direct production. ❑ Sales to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin#10. (May not be used for personal hotel rooms and meals.) ❑ Sales of tangible personal property predominately used(greater then 50 percent)in providing public transportation-provide USDOT#. A person or corporation who is hauling under someone else's motor carrier authority,or has a contract as a school bus operator,must provide their SS#or FID#in lieu of a State ID#in Section#1. USDOT# ❑ Sales to persons,occupationally engaged as farmers,to be used directly in production of agricultural products for sale. Note:A farmer not possessing a State Business License#may enter a FID#or a SS#in lieu of a State ID#in Section#1. ❑ Sales to a contractor for exempt projects(such as public schools,government,or nonprofits). ® Sales to Indiana Governmental Units(agencies;cities,towns,municipalities,public schools,and"state universities). ❑ Sales to the United States Federal Government-show agency name. Note:A U.S.Government agency should enter its Federal Identification Number(FID#)in Section#1 in lieu of a State ID#. ❑ Other-explain. I hereby certify under the penalties of perjury that the property purchased by the use of this exemption certificate is to be used for an exempt purpose pursuant to the State Gross Retail Sales Tax Act,Indiana Code 6-2.5,and the item purchased is not a utility,vehicle,watercraft or aircraft. y`- I confirm my understanding that misuse. either negligent r' enttonal),and/or fraudulent use of this certificate may subject both me personally y and/or the business entity I represent a imposition ter ,and civil and/or criminal penalties. r Signature of Purchaser Date Printed Name DIANA L CORDRAY Title CLERK-TREAURER The Indiana Department of Revenue may request verification o registration in another state if you are an out-of-state purchaser. Seller must keep this certificate on file to support exempt sales. VOUCHER NO. WARRANT NO. ALLOWED 20 Aramark IN SUM OF$ 22512 Network Place Chicago, IL 60673-1225 $877.22 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 I 15814044 I 43-560.011 $877.22 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except fay, July 18, 2014 StreeP6Wr4 ggl gpioner Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 07/11/14 15814044 $877.22 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer