HomeMy WebLinkAbout101099 SIMPLIFILE INDIANA RETAIL TAX EXEMPTPage 1 of 1
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FEDERAL EXCISE TAX EXEMPT
O PURCHASEIr,ORrD�nUMBER
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MU''ST AAPP�IEAARR 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
12/13/2017 369043
SIMPLIFILE Dept of Community Service
VENDOR 4844 NORTH 300.WEST,SUITE 300 SHIP
TO 1 Civic Square
Carmel, IN .46032
PROVO, UT 84604-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21696
QUANTITY UNIT OF MEASUREDESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-406.00
1 Each Liens and Release of Liens $2,686.00 $2,686.00
Sub Total $2,686.00
, ,,,,,,,, , ,i,, ,, 1 i, ' ,:;''1 ; 2 \
Send Invoice To: . .
Dept of Community Service
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $2,686.00
SHIPPING INSTRUCTIONS `A1PARTP VOUCHER
OFTHEVOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS
HAS THETHE P.O.PROPER SNUMBERWIS MADEORN A
AND EVERY INVOICE AND VOUCHER
*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 /7' --' '"�,
ORDERED BY
Mike Hollibaugh
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
TITLE Director
CLERK-TREASURER
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CONTROL NO. 101099 \� �