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CERTIFICATEINDNARET NOI L.
003120155TAEXEMPT 002 0 PAGE 1
C itY 0 i N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT 53983
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
1/10/2020 01/14/20 22377 366118 Cleaning Supplies Week of 1/13/19
Ace- Pak Products Inc. Parks Maintenance
12602 Double Eagle Drive 1427 E. 116th Street ATTN: Courtney
VENDOR Carmel, IN 46033 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
10.000 each 63001042F- Medium blue nitrile gloves $ 6.890 $ 68.90
10.000 each 15704349- 56 gallon trash bags $ 18.490 $ 184.90
4.000 each 15704348-clear 56 gallon trash bags $ 34.990 $ 139.96
5.000 each 15334073- Black can liner for dog pots $ 14.790 $ 73.95
12.000 each 60060260- Rags in a box $ 13.490 $ 161.88
GLAccount# 1125401-4238900
Send Invoice To:
$ 629.59
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 Courtney Weintraut
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 53983 VIE 1NID 0 IR CO Y