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CERTIFICATE NO.003120155 002 0
City
o 'a m PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 51359
35-60000972
ONE CIVIC SQUARE
s:r RIfSEL'ir}p 1 }L+ 1332-2THIS NUMBERMUST APPEAR ON CES,NP
VOUCHER,DELIVERY MEMO,PACKING ISLIPS,
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
5/17/2018 05/21/18 16355 00353324 2018 Premier Agency Package Renewal
NRPA Administration Office
22377 Belmont Ridge Road 1411 E. 116th Street
VENDOR Ashburn,VA 20148-45016 SHITO
Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Agency Membership 6/30/17-6/29/18 $ 1,500.0000 $ 1,500.00
GLAccount#1125101-4355200
Send Invoice To:
$ 1,500.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
▪ C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER 44\
DOCUMENT CONTROL NO. 51359 VENDOR COPY