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INDIANA RETAIL TAX EXEMPT Page 1 1
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101147
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 362456
NEOGOV Human Resources
VENDOR 222 N SEPULVEDA BLVD#2000 SHIP I Civic Square
TO
Carmel, IN 46032-
ED SEGUNDO,
6032-ED.SEGUNDO,CA 90254
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS.
_ FREIGHT :.
21825
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1201 . . Fund: 101 General Fund
Account: 43-419.03
e support $4,576.69' $4,576.69
1 Each Software u ort fees
Sub Total $4,576.69
S
f _
Send Invoice To: :, -
Human Resources
1 Civic Square
'dam � 4 � � � rCarmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 ACCOUNT Y PROJECT ^ PROJECT ACCOUNT 1 AMOUNT
PAYMENT $4,576.69
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 ,/��?- .���, 7 i�__,_.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY 4 /\
Barbara Lamb `�
TITLE Director `n/\
CONTROL NO. 101147 CLERK-TREASURER V