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C CERTIFICATE NO.003120155 002 0
City o i ,Orr, ?
FEDERAL EXCISE TAX EXEMPT PURCHASE ORDER NUMBER 38916
35-60000972
011:.CIVIC:SQUARE .
• rr+SR)i-L,NOVARA 4i.e22-2..u= THIS NUMBER MUST APPEAR ON INVOICES,MP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
I
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
8/5/2015 08/10/15 6234 Pool Chemicals for Inlow
1
Spear Corp MCC-West
P.O. Box 3 1235 Central Park Drive East
VENDOR Roachdale, IN 46172 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY' I UNIT OF MEASURE I DESCRIPTION UNIT PRICE I EXTENSION
9.000 each Acid Magic 15 Gallon $85.5000 $769.50
GLAccount# 1125300-4238900
Send Invoice To:
$769.50
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT
• AA'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.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS, ORDERED BY Eric Mehl kA" � %I. 1,
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 4-;-
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO.
TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 38916 VENDOR COPY