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INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
x
PURCHASE ORDER NUMBER
.. " FEDERAL EXCISE TAX EXEMPT
54659
35-60000972
DUE UWIU SQUARE
CARMEL,, INal.11IIA„N „„ O 32-2 5,8,4 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
Possible New Vendor
7/24/2020 07/26/20 23701 W-9 attached. Initial Services Agreement for Office 365
Mirazon Group, LLC, The Administration Office
1640 Lyndon Farm Court Suite 102 1411 E. 116th Street
VENDOR Louisville, KY 40223 SOHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
4.000 each Hourly rate to build new domain controller at City of Carmel $ 170.000 $ 680.00
2.000 each Hourly rate to configure Azure AD Connect to sync accounts to $ 170.000 $ 340.00
Office 365
6.000 each Hourly rate to create new user accounts $ 170.000 $ 1,020.00
GLAccount# 1125101-4341955
Send Invoice To:
$2,040.00
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 ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 54659 Il,,,;;;III DOR COPY