54411 FERGUSON
PAGE 1
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
54411
35-60000972
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 DATEDATE REQUIREDREQUISITION NO.VENDOR NO.DESCRIPTION
5/12/202005/17/2023238PPE for AO Extra Inventory (COVID19)
117785
Ferguson (Formerly HP Products) Administration Office
P.O. Box 7759411411 E. 116th Street
SHIP
Chicago, IL 60677-5941Carmel, IN 46032
VENDOR
TO
CONFIRMATIONBLANKETCONTRACTPAYMENT TERMSFREIGHT
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
10.000boxHP Disposable Nitril Gloves (Small) #Item #5169191$ 9.850$ 98.50
10.000boxHP Disposable Nitril Gloves (Medium) #Item #5169189$ 9.850$ 98.50
10.000boxHP Disposable Nitril Gloves (Large) #Item #5169190$ 9.850$ 98.50
10.000boxHP Disposable Nitril Gloves (XLarge) #Item #5169188$ 9.850$ 98.50
GLAccount# 1125101-4359016
Send Invoice To:
$ 394.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
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
AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS
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.
Dawn Koepper
ORDERED BY
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
TITLE
CLERK-TREASURER
VENDOR COPY
DOCUMENT CONTROL NO.54411