HomeMy WebLinkAbout50037 REPUBLIC SERVICES #761 City � 11TAX EMPT
INDIANA RETAIL01PAGE 1
FEDERAL EXCISE TAX EXEMPT 50037
3540000972
ONE CHIC
Cr+41.T=L,t171ra'IA THIS NUMBER MUST APPEAR ONINVOICES,ALP
VOUCHER.DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
7/6/2017 06/24/17 13061 358593 Roll off dumpster for Flowing Well(Deck removal)
Republic Services#761 Parks Maintenance
P O Box 9001099 1427 E.116th Street ATTN:Courtney
VENDOR Louisville,KY 40290-1099 SHIP
HP Carmel,IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE I DESCRIPTION I UNIT PRICE r EXTENSION
1.000 each delivery fee $88.0000 $88.00
1.000 each pick up $238.0000 $238.00
1.000 each 4.5 tons of disposal $169.1100 $169.11
GLAccount#1125401-4350101
Send Invoice To:
$495.11/
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT _._...
PAYMENT
NP 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 N AN UNOBLIOATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR TIE ABOVE ORDER.
• COD SHIPMENTS CANNOT SE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Michael Allen
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 50037 V"NDC:'t CC:.')Y