HomeMy WebLinkAbout56110 STAPLES BUSINESS ADVANTAGE ar e,
INDIANA RETAIL TAX EXEMPT PAGE 1
(2,4 ty h
qy CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 56110
35-60000972
ONE CIVIC SQUARE
C.ARMEL,IN DIAILIA 46O 32_2 84 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
12/6/2021 12/08/21 27055 361528 AO Office/Kitchen Supplies& Equipment
Staples Business Advantage Administration Office
Dept DET 2368 P.O. Box 83689 1411 E. 116th Street
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 LaserJet Pro M404dn Network Monochrome Laser Printer $233.060 $233.06
with Duplexing (W1A53A) Item#: 24395500
GLAccount# 1125101-4341955
1.000 each HON Convergence Vinyl Task Chair with Seat Slide, $ 199.990 $ 199.99
Adjustable Arms, Black(HONCMY1AUR10) Item#: 2729611
1.000 each Delivery& Install on Chair $49.990 $49.99
GLAccount# 1125101-4463000
2.000 each Green Mountain Breakfast Blend Coffee, Keurig®K-Cup® $ 13.990 $27.98
Pods, Light Roast, Decaf, 24/Box(5000082433/7522) Item#:
719434
1.000 each Green Mountain Regular Variety Pack Coffee, Keurig®K- $ 57.990 $ 57.99
Cup®Pods, Variety Pack Roast, 88/Carton (GMT6501CT)
Item#: 260696
2.000 each ON CONTRACT Expo Low Odor Dry Erase Markers, Chisel $ 6.500 $ 13.00
Point, Assorted, 8/Pack(80678) Item#: 474335
1.000 each Softsoap Moisturizing Hand Soap with Aloe, Refill, 1 Gallon $ 13.050 $ 13.05
(201900) Item#: 792739
2.000 each HP 58A Black Standard Yield Toner Cartridge Item#: $ 89.440 $ 178.88
24398981
Send Invoice To:
$ 822.26
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. 56110 V N ID 0 IR COIF Y
INDIANA RETAIL TAX EXEMPT PAGE 2
qytIfy 1-11,
1,u ar CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 56110
35-60000972
ONE CIVIC SQUARE
C.ARMEL,IN DIAILIA 4E032-2 84 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
12/6/2021 12/08/21 27055 AO Office/Kitchen Supplies& Equipment
Staples Business Advantage Administration Office
Dept DET 2368 P.O. Box 83689 1411 E. 116th Street
VENDOR Chicago, IL 60696-3689 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
1.000 each 2022 TRU REDTM 17"x 22" Desk Pad Calendar, Black/White $ 1.960 $ 1.96
(TR12951-22) Item#: 24471073
1.000 each Microsoft Desktop 2000 Wireless Keyboard & Mouse, Black $27.490 $27.49
(M7J-00001) Item#: 323847
3.000 each Kleenex Standard Facial Tissue, 2-Ply, 144 Sheets/Box, 3 $ 6.290 $ 18.87
Boxes/Pack(50219) Item#: 056014
GLAccount# 1125102-4230200
Send Invoice To:
$ 822.26
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. 56110 VIF::INIDO COPY