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CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101962
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
9/20/2018 357831 Annual Equipment Maintenance
SERVICE EXPRESS INC ICS
VENDOR 3854 BROADMOOR AVE SE SHIP 31 1st Avenue N.W.
TO Carmel, IN 46032-
GRAND RAPIDS, MI 49512- Timothy Renick (317)571-2576
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
29442
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1115 Fund: 101 General Fund
Account: 43-515.01
1 Each Annual Equipment Maintenance $6,396.00 $6,396.00
Sub Total $6,396.00
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Send Invoice To: - ,
ICS ',Agreement No. 22163 y
Timothy Renick /
31 1st Avenue N.W. \\,,,,,, ,
Carmel, IN 46032- �, "may
(317)571-2576 PLEASE INVOICE IN DUPLICATE
DEPARTMENT i ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $6,396.00
SHIPPING INSTRUCTIONS 'A/P 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 �' (-tel
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 �i
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Timothy Renick James Crider
TITLE Director Administration
CONTROL NO. 101962 CLERK-TREASURER