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INDIANA RETAIL TAX EXEMPT Page 1 of 1
ity Cof Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 100421
ONE CIVIC SQUARE L 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 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
5/5/2017 033825 Power Adapter
CDW GOVERNMENT INC Communications
VENDOR 75 REMITTANCE DR SHIP 31 1st Avenue N.W.
SUITE 1515 TO Carmel, IN 46032-
CHICAGO, IL 60675--1515 (317)571-2576
PURCHASE ID 1 BLANKET CONTRACT PAYMENT TERMS FREIGHT
15133
111 QUANTITY 1 UNIT OF MEASURE DESCRIPTION UNIT PRICE j EXTENSION
Department: 1115 Fund: 101 General Fund
Account: 42-302.00
1 Each 4357765 Microsoft Power adapter 102W $91.07 $91.07
Sub Total $91.07
Send Invoice To:
Communications Quote No. HWZN230
31 1st Avenue N.W.
Carmel,IN 46032-
(317)571-2576 DUPLICATE
DEPARTMENT ACCOUNT
INVOICECT i. PROJECT ACCOUNT rAMOUNT _I
i.. J
PAYMENT $91.07
`NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
*SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D.SHIPMENT CANNOT BE ACCEPTED, THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL ) \�
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ,—i. , �� i \
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY h
Terry Crockett
TITLE Director
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CONTROL NO. 100421 CLERK-TREASURER