HomeMy WebLinkAbout54395 CARAHSOFT TECHNOLOGY INDIANA RETAIL TAX EXEMPT PAGE 1
City of, hPURCHASE ORDER NUMBER
CERTIFICATE NO.003120155 002 0
i N
U FEDERAL EXCISE TAX EXEMPT 54395
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
5/6/2020 05/11/20 23210 Electronic Signature Subscription (COVID19)
Carahsoft Technology Administration Office
11493 Sunset Hills Road, Suite 100 1411 E. 116th Street
VENDOR Reston, VA 20190 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Parks Prorated fee for Docusign Subscription with the City $2,889.320 $2,889.32
GLAccount# 1125101-4359016
Send Invoice To:
$2,889.32
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 AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54395 VIE 1NID 0 IR CO Y