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CERTIFICATE NO.003120155 002 0 PURCHASE ORDERgqNUMBER
FEDERAL EXCISE TAX EXEMPT 1® 1 085
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
12/13/2017 00351085
MEDIA FACTORY Dept of Community Service
VENDOR 481 GRADLE DRIVE SHIP: 1 Civic,Square
T0 Carmel, IN 46032-. .
CARMEL,IN 46032-
PURCHASE ID .BLANKET CONTRACT PAYMENT TERMS FREIGHT
21667
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: .1192 Fund: 101 General Fund
Account: •
42-301.00
1 Each Misc::printing $2,162.28 $2,162.28
Sub Total $2,162.28
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Send Invoice To:
Dept of Community Service
1 Civic Square .
Carmel, IN 46032- x
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $2,162.28
SHIPPING INSTRUCTIONS •NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
'SHIP PREPAID. PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
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
ORDERED BY
SHIPPING LABEL /�� ,/,"
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ( — ,--iv; \P\
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT TH \f 4
ERETO.
Mike Hollibaugh `
TITLE Director
CONTROL NO. 101085 CLERK-TREASURER