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INDIANA RETAIL TAX EXEMPT Page 1 of 1
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f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
Iit'-T ® FEDERAL EXCISE TAX EXEMPT 100445
ONE CIVIC SQUARE 135-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
CARMEL, INDIANA 46032-2584 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
511612017 371098
1 NATIONAL BUSINESS FURNITURE Department of Law
VENDOR 770 SOUTH 70TH STREET SHIP 1 Civic Square
TO Carmel, IN 46032-
MILWAUKEE,WI 53214- Douglas C. Haney (317)571-2472
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
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15377 I I
QUANTITY UNIT OF MEASURE `
DESCRIPTION UNIT PRICE EXTENSION
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Department: 1180 Fund: 209 Deferral Fund
Account: 44-630.00
1 Each Furniture and Fixtures $1,314.00 $1,314.00
Sub Total $1,314.00
Send Invoice To:
Department of Law
Douglas C. Haney
1 Civic Square
Cannel,IN 46032-
(317)571-2472 PLEASE INVOICE IN DUPLICATE
— — — PROJECT ACCOUNT AMOUNT I
L DEPARTMENT ACCOUNT I PROJECT
PAYMENT $1,314.00
•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 —_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY —
Douglas Haney �
TITLE Corporation Counsel <3\ `!k-
CONTROL NO. 100445 CLERK-TREASURER1