HomeMy WebLinkAbout55071 REPUBLIC SERVICES #761 r
INDIANA RETAIL TAX EXEMPT PAGE 1
11,1, „Aki
CERTIFICATE NO.003120155 002 0
' 0'0 111x
PURCHASE ORDER NUMBER
II.. I, FEDERAL EXCISE TAX EXEMPT
55071
35-60000972
DUE UWIU 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
1/7/2021 01/12/21 24640 358593 2021 Parks Office Trash Service
Republic Services#761 Parks Maintenance
P O Box 9001099 1427 E. 116th Street ATTN: Courtney
VENDOR Louisville, KY 40290-1099 SOHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
12.000 each Jan - Dec 2021 monthly trash service $ 150.000 $ 1,800.00
12.000 each Jan - Dec 2021 monthly recycle service $55.000 $ 660.00
GLAccount# 1125401-4350101
Send Invoice To:
$2,460.00
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. 55071 II,,,;;;III DOR COPY