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INDIANA RETAIL TAX EXEMPT Page 1 of 1
tof CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
�] FEDERAL EXCISE TAX EXEMPT 26697
ONE CIVIC SQUARE 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
1/5/2017 364577
WORKSPACE SOLUTIONS Carmel City Court
!VENDOR 2208 PRODUCTION RD SHIP 1 Civic Square
TO Carmel, IN 46032-
FORT WAYNE, IN 46808
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS T FREIGHT
11639
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE ' EXTENSION
Department: 1301 Fund: 506 Judical Salary Fees Fund
Account: 44-630.00
1 Each Office Furniture $10,301.18 $10,301.18
Sub Total $10,301.18
Send Invoice To:
Carmel City Court
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT 1 AMOUNT
PAYMENT $10,301.18
SHIPPING INSTRUCTIONS 'A!P 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
*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
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'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 Brea wG Pr
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Brian Poindexter
TITLE Judge
CONTROL NO. 26697 CLERK-TREASURER