HomeMy WebLinkAbout33287 APA Payment CenterCi
of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35-60000972
PAGE
PURCHASE ORDER NUMBER
33287
THIS NUMBER MUST APPEAR ON INVOICES, AIP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
12/15/2015
VENDOR
APA - Payment Center
97774 Eagle Way
Chicago, IL 60678
SHIP
TO
DOCS Department
1 Civic Square
Carmel, IN 46032
(317) 571-2418
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 43-570.04
1 Each APA National Conference
Send Invoice To:
DOCS Department
1 Civic Square
Carmel, IN 46032 -
PLEASE INVOICE IN DUPLICATE
$3,000.00 $3,000.00
Sub Total: $3,000.00
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1192 DOCS
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.0 D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PAYMENT $3,000.00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCH HAS THE PROPER SWOR AFFIDAVIT ATTACHED.
• I HER ERT Y T THERE IS UNOBLIGATED BALANCE IN
ORDERED BY S Ji
OF
TITLE
CLERK -TREASURER
DOCUMENT CONTROL NO. 33286 A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE