HomeMy WebLinkAbout55319 HOOSIER PORTABLE RESTROOMS INC (2) (2-;107 111,
INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO.003120155 002 0
N PURCHASE ORDER NUMBER
U FEDERAL EXCISE TAX EXEMPT
55319
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
7/20/2021 04/17/21 26061 Change: Portalet Restrooms for Inlow Spring 2021
Hoosier Portable Restrooms Inc Parks Maintenance
2201 E 99th Street 1427 E. 116th Street ATTN: Courtney
VENDOR Indianapolis, IN 46280 SHIP Carmel, IN 46032
To
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
12.000 each 2 temporary units- Rental/cleaning of EAU enhanced portalet $40.000 $480.00
for Inlow Park until construction begins(possibly mid-April thru
mid-july- 12 weeks)
12.000 each Second Unit- Not listed for cost on first line item $40.000 $480.00
GLAccount# 1125411-4353099
Send Invoice To:
$ 960.00
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 AND SUPPLEMENT THERETO. TITLE Purchasing Administrator
CONTROLLER
DOCUMENT CONTROL NO. 55319 VII=::INIDO COPY