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INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
x
PURCHASE ORDER NUMBER
.. "�II FEDERAL EXCISE TAX EXEMPT
54741
35-60000972
ONE CIVIC SQUARE
CARMEL,, INaNIl1 IUD „„46032—.25,8,4 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
8/10/2020 08/12/20 23880 374011 Software Estimate for Changes to Purchasing Software
Fraxion Spend Mangement, LLC Administration Office
3131 Elliott Ave, Suite 450 1411 E. 116th Street
VENDOR Seattle, WA 98121 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Perform requirements to provide an estimate to change $ 740.000 $ 740.00
information on the purchase order forms
GLAccount# 1125101-4341955
Send Invoice To:
$ 740.00
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. 54741 II,,,;;;III DOR COPY