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�� INDIANA RETAIL TAX EXEMPT Page 1 of 7
of37 Carmel ---- PU HASE E-. --
CERTIFICATE NO.003120155 002 0 PURCHAS®ORD ORDER UMBER
FEDERAL EXCISE TAX EXEMPT 1 ' i
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL,INDIANA 46032-2584 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
12/14/2017 372128
SUPERION, LLC Dept of Community Service
VENDOR BANK OF AMERICA SHIP 1 Civic Square
12709 COLLECTION CENTER DRIVE TO Carmel, IN 46032-
CHICAGO,IL 60693-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
21756
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-515.02
1 Each Software Support $54,641.86 $54,641.86
Sub Total $54,641.86
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Send Invoice To: ;k
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Dept of Community.Service
1 Civic Square
Carmel, IN 46032-
PLEASE
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INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $54,641.86
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 SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 -- c
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY
Mike Hollibaugh James Crider
TITLE Director Administration
CONTROL NO. 101112 CLERK-TREASURER