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CERTIFICATE• f C
55 002 0
EXCISE PURCHASE ORDER NUMBER
FEDERAL
TAX EXEMPT 55574
3
00972
ONE CIVIC SQUARE
CARMEL,NOANA 2-2.584 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 ......................................_1
PURCHASE ORDER DATE.DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/11/2021 3/21 25687 W-9 Attached Tree Protectors
Tree Pro-Lafayette Marketing, Inc. Parks Maintenance
3180 W. 280 N. 1427 E. 116th Street ATTN: Courtney
VENDOR West Lafayette, IN 47906 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE J EXTENSIO
N
1.750 each Miracle tube 36"tree protector+White oak stake 36" $ 142.000 $248.50
1.000 each Shipping $50.000 $50.00
GL GIFT FUND 853-5023990
Send Invoice To:
$298.50
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 Lana Ramer
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Volunteer Coordinator
CONTROLLER
DOCUMENT CONTROL NO. 55574 VENDOR COPY