HomeMy WebLinkAbout103365 HEALTHCARE WASTE MGMT INC 0 INDIANA RETAIL TAX EXEMPT Page 1 of 1
City J�o f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103365
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
12/5/2019 373754 Pharmaceutical Waste Removal Program
HEALTHCARE WASTE MGMT INC Carmel Fire Department
VENDOR 700 E 107TH ST SHIP 2 Civic Square
TO Carmel,IN 46032-
CHICAGO, IL 60628-
PURCHASE ID BLANKET : CONTRACT PAYMENT TERMS FREIGHT
42229
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account:.43-509.00
1 Each. Pharamceutical Waste Removal-5 Gallon Mail Back System $199.99 $199.99
Sub Total $199.99
I
Send Invoice To:
Carmel Fire Department
2 Civic Square ay
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $199.99
SHIPPING INSTRUCTIONS •AIP 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\
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder
TITLE Accreditation Budget Administrator
CONTROL NO. 103365 CLERK-TREASURER