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City
O i r 1wi N CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT 53994
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
1/13/2020 01/16/20 22393 366118 Cleaning Supply Order for the week of 1/11/2020
Ace- Pak Products Inc. MCC- East
12602 Double Eagle Drive 1235 Central Park Drive East
VENDOR Carmel, IN 46033 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
5.000 case 15604349 Black Can Liner 43"x 48" 26 Mic 56 Gal [1.03 Mils] $ 18.490 $ 92.45
6.000 case 60080343 EcoSoft 13000 Facial Tissue-2Ply 8"x 8" [100 per $22.490 $ 134.94
Box]
1.000 case 60050495 White C-Fold Towels 10.25"x 13" $25.990 $25.99
1.000 case 15704348 Clear Can Liner 43"x 48" 26 Mic 56 Gal [1.03 $ 34.990 $ 34.99
Mils]
1.000 case 63000500 RubberMaid Compatible Changing Station Liners $ 69.990 $ 69.99
4.000 box 63000504 Black Urinal Mat with Fresh Scent $43.950 $ 175.80
1.000 box 15163271 12-16 GALLON TRASH BAGS $25.490 $25.49
1.000 box 63000721 Drain Opener(QT bottles) $ 31.990 $ 31.99
1.000 each 60070400 White 2 Ply Household Paper Towel -85 Sheets $22.490 $22.49
1.000 each 60025022 Household 2-Ply Toilet Paper-500 sheets/Roll $25.490 $25.49
GLAccount# 1093000-4238900
Send Invoice To:
$ 639.62
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 Freddy Delfin
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 53994 VIE 1NID 0 IR CO Y