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(21;ty na, h '',.. „..„,„. , qy . . ., . . 10ERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 58578
35-60000972
ONE CIVIC SQUARE
CARMEL,IN DIA.NA 4611S2-2 n4i, 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
8/21/2023 08/20/23 32452 366118 Park Cleaning Supplies Week 8/21/23
Ace- Pak Products Inc. Parks Maintenance
12602 Double Eagle Drive 1427 E. 116th Street
VENDOR Carmel, IN 46033 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
12.000 each 60060260 Rags-In-a-Box $ 13.990 $ 167.88
4.000 each 15704348 Clear Can Liner 43x48, 56 gal (recycle) $ 38.990 $ 155.96
12.000 each 15604349 Black Can Liner 43x48, 56 gal (trash) $23.990 $287.88
8.000 each 63001042F Nitrile Disposable Gloves Powder Free (M) $ 11.990 $ 95.92
8.000 each 6301043F Nitrile Disposable Gloves Powder Free (L) $ 11.990 $ 95.92
8.000 each 63001044F Nitrile Disposable Gloves Powder Free (XL) $ 11.990 $ 95.92
4.000 each 63000806 Generic Wipes (75ct) $ 3.990 $ 15.96
1.000 each 63000452 Lysol Spray 32oz bottles, 8/case $ 31.200 $ 31.20
8.000 each CLR Brilliant Bath-26 oz Trigger Bottle $4.990 $ 39.92
2.000 each 63000440 Clorox EcoClean Disinfectant Cleaner-Case of 9 $44.990 $ 89.98
GLAccount# 1125423-4238900
Send Invoice To:
$ 1,076.54
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.OD SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Cody McCollum
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Parks Operations Manager-Custodial
CONTROLLER
DOCUMENT CONTROL NO. 58578 Vlliliii1NID0IF C 0 II::aY