Loading...
HomeMy WebLinkAbout317810 10/25/2017 CITY OF CARMEL, INDIANA VENDOR: 367794 ® E ONE CIVIC SQUARE TAKEFORM CHECK AMOUNT: $********39.00* =1 ?; CARMEL, INDIANA 46032 11601 MAPLE RIDGE ROAD CHECK NUMBER: 317810 +, MEDINA NY 14103 CHECK DATE: 10/25/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1091 4230200 64968 39.00 OFFICE SUPPLIES w 0 \ k c / > -N 2 o 0 0 P Ek 0 40 � � w # k 2 0 o c % k g o 0 © 2 5 — 3 [ o m --I 9 ° \ 7 § 0 � f f ] § % 2 0 2 , $ \ q 0 2 w OE m m U) g 0 P � � @ km m CD X / z ( # 4A 69 - R > 0 2 P % \ 3 2 0 a ] / E D ° � m CD ƒ $ E g M E ] CL q CD © 0 G 3 0 kCD 69 m 9 0 0 ■ @ (7 \ \ k 7 & m m ) ; $ \ S E 7 m F 2 E 0 o E - g E M » = E " (D E . / / / / 0 / o / m CD | / o Quorum Group, LLC. 13BA Invoice#: 64968 IF D 0 C l 16 2017 Invoice Date: 10/12/17 11601 Maple Ridge Road PO#: XX-5834 Medina, NY 14103 BY: .............................. 800-528-1398 Payment Terms: Net 30 Bill To: Carmel Clay Parks & Recreation Ph: (317) 573-4026 Fax: (317) 571-4136 Attn: Dawn Koepper Email: dkoepper@carmelclayparks.com 1411 E. 116th Street Carmel, IN 46032 Job Name: CAR0061: Carmel Clay Parks Quantity Unit Net Net Line Description tY Price Price Ext 1 Type L.2a: 5x5 Workstation (Pin) 1 32.00 32.00 Net Subtotal: $32.00 Shipping and Handling: $7.00 Net Total: Balance Due(USD): $39.00 Terms are Net 30. Past due accounts are subject to 1% interest per month. We reserve the right to hold future orders or ship future orders COD if terms are not adhered to. Purchaser is responsible for all fees and expenses including but not limited to, attorneys and collection fees incurred by Takeform in the enforcement of this agreement. Credit cards accepted. Please complete form below and fax to Accounts Receivable at 585-798-8889 Payment Options: Carmel Clay Parks&Recreation Invoice # ❑Visa MasterCard Discover nAmerican Express Balance Due: $39.00 Cardholder's Name: CVV2#: Card Number: Expiration Date: Card Billing Address: Signature: Print Date:10/13/2017 8:31:52AM Page 1 of 1