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INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT
55659
35-60000972
ONE CIVIC SQUARE
CARMEL,INDIANA 4E0 32-2584 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
7/6/2021 06/30/21 25851 364923 Staff Uniform Badge Supplies
Imprint Plus Administration Office
c/o Bank of America 9240 Colle 1411 E. 116th Street
VENDOR Chicago, IL 60693 SHIP Carmel, IN 46032
To
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
5.000 each Badge Inserts 5Pk $ 35.000 $ 175.00
250.000 each Badge Plate $ 3.500 $ 875.00
250.000 each Badge Cover $ 0.650 $ 162.50
250.000 each Magnet $ 1.800 $450.00
1.000 each Freight& Insurance $ 64.690 $ 64.69
GLAccount# 1125102-4230200
Send Invoice To:
$ 1,727.19
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 Lynn Russell
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE HR Director
CONTROLLER
DOCUMENT CONTROL NO. 55659 VII=::INIDO COPY