HomeMy WebLinkAbout54194 REPUBLIC SERVICES #761 INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
City of
i N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT 54194
35-60000972
ONE crnc 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
2/28/2020 01/21/20 22443 358593 Construction Dumpster Rental
Republic Services#761 Parks Maintenance
P O Box 9001099 1427 E. 116th Street ATTN: Courtney
VENDOR Louisville, KY 40290-1099 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each 20 yard construction debris dumpster delivery fee $ 150.000 $ 150.00
1.000 each Haul Fee $ 180.000 $ 180.00
2.550 each Debris Dispoal Fee per Ton $ 38.000 $ 96.90
GLAccount# 1125401-4350400
Send Invoice To:
$426.90
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 Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54194 VIE 1NID 0 IR CO Y