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� ' CERTIFICATE NO.003120155 002 0
City
Carmel
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 53949
35-60000972
ONE CIVIC SQUARE
E:API'�IEL,IIdDANA 460, 2-25,S4, 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
1/8/2020 01/12/20 22313 358593 2020 Parks Office Trash Service
Republic Services#761 Parks Maintenance
P O Box 9001099 1427 E. 116th Street ATTN: Courtney
VENDOR Louisville, KY 40290-1099 TOIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
12.000 each Jan - Dec 2020 monthly trash service $ 150.000 $ 1,800.00
12.000 each Jan - Dec 2020 monthly recycle service $ 55.000 $ 660.00
GLAccount# 1125401-4350101
Send Invoice To:
$2,460.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• A/P 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 ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 53949 Vlliliiil 11..)()1:R C 0111)y