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Cit of CIiarnrie1 CERTIFICATE N0.003120155 002 0 _..A
PURCHAiSEoOoR��NUMBER
FEDERAL EXCISE TAX EXEMPT '' U8
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
11/29/2017 357831 Equipment Service Agreement-expires 11/30/18
SERVICE EXPRESS Information Systems
VENDOR 4845 CORPORATE EXCHANGE SHIP 31 1st Ave N.W:
TO Carmel, IN 46032-
GRAND RAPIDS, MI 49512- Timothy Renick (317)571-2567
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21047
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1202 Fund: 101 General Fund
Account: 43-515.01
1 Each Eqmt Service agreement $4,643.44 $4,643.44
Sub Total $4,643.44
•
Send Invoice To:
Information Systems \Service Agreement 22163 , s
Timothy Renick
31 1st Ave N.W.
Carmel, IN 46032-
(317)571-2567 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $4,643.44
SHIPPING INSTRUCTIONS •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
'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 `��` ►= A �' 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Timothy Renick
TITLE Director
CONTROL NO. 100978 CLERK-TREASURERVI