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CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101590
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
4/18/2018 369620 LaserFiche License fee
MCCI INNOVATIONS Department of Law
VENDOR PO BOX 2235 SHIP 1 Civic Square
TO Carmel, IN 46032-
TALLAHASSEE, FL 32316- Douglas C. Haney (317)571-2472
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
25178
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1180 Fund: 101 General Fund
Account: 44-632.02
1 Each Software $924.00 $924.00
Sub Total $924.00
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444- 4,4114,44 :14
Send Invoice To:
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Department of Law � , �.
Douglas C. Haney ,,
1 Civic Square ` �` 4
s
Carmel,IN 46032- 1 ; ~45 '
(317)571-2472 PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $924.00
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 `_"'V-, . \6C)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY -
Douglas Haney `
‘ i,
TITLE Corporation Counsel V\` II
CONTROL NO. 101590 CLERK-TREASURER