HomeMy WebLinkAbout55288 STAPLES BUSINESS ADVANTAGE INDIANA RETAIL TAX EXEMPT PAGE 1
1,n„ CERTIFICATE NO.003120155 002 0
N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT
55288
35-60000972
ONE CIVIC SQUARE
C.ARMEL,IN DIANA 460 32.-.256,4 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
4/2/2021 04/06/21 25127 361528 PNR Printer Supplies
Staples Business Advantage Parks Maintenance
Dept DET 2368 P.O. Box 83689 1427 E. 116th Street ATTN: Courtney
VENDOR Chicago, IL 60696-3689 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each HP 410A Black Toner Cartridge, Standard (CF410A) Item# $ 65.180 $ 65.18
1878689
1.000 each HP 410A Cyan/Magenta/Yellow Toner Cartridges, Standard $277.170 $277.17
Yield, 3/Pack(CF251AM) Item#2596065
GLAccount# 1125413-4230200
Send Invoice To:
$ 342.35
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 Courtney Weintraut
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE PNR Maintenance Coordinator
CONTROLLER
DOCUMENT CONTROL NO. 55288 V N ID 0 IR COIF Y