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w CERTIFICATE NO.003120155 002 0
C
itY O r 9 i N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT 54411
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
5/12/2020 05/17/20 23238 117785 PPE for AO Extra Inventory(COVID19)
Ferguson (Formerly HP Products) Administration Office
P.O. Box 775941 1411 E. 116th Street
VENDOR Chicago, IL 60677-5941 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
10.000 box HP Disposable Nitril Gloves(Small)#Item#5169191 $ 9.850 $ 98.50
10.000 box HP Disposable Nitril Gloves(Medium)#Item#5169189 $ 9.850 $ 98.50
10.000 box HP Disposable Nitril Gloves(Large)#Item#5169190 $ 9.850 $ 98.50
10.000 box HP Disposable Nitril Gloves(XLarge)#Item#5169188 $ 9.850 $ 98.50
GLAccount# 1125101-4359016
Send Invoice To:
$ 394.00
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 AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54411 VIE 1NIID0.IR C.O1I3Y