HomeMy WebLinkAbout53459 ROBERTS DISTRIBUTORS, LP INDIANA RETAIL TAX EXEMPT PAGE 1
of PURCHASE ORDER NUMBER
:J¶`.,. }i Carniel CERTIFICATE NO.003120155 002 0
FEDERAL EXCISE TAX EXEMPT 53459
35-60000972
ONE CIVIC SQUARE. -
CARMEL,INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
8/21/2019 08/26/19 21225 W-9 Attached Photography Equipment Requested per Assistant Director of
au-� G� Parks&Recreation
Roberts Distributors LP J 3 539 Administration Office
220 E Saint Clair Street 1411 E. 116th Street
VENDOR Indianapolis, IN 46204 TOIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each Item#DJI-00330-DJI Mavic2 Zoom Drone w/Smart Controller $ 1,569.000 $1,569.00
1.000 each DJI Case for Mavic2 Zoom $ 169.000 $ 169.00
GLAccount#1125101-4359000
Send Invoice To:
$ 1,738.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• MP 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
DOCUMENT CONTROL NO. 53459 VENDOR COPY