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1 11 1 I`� CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER,
I FEDERAL EXCISE TAX EXEMPT
s:, 35- 60000972
pl ONE CIVIC SQUARE
THIS NUMBER M
aE4AR ON INVOICES, MP
CARMEL, INDIANA 46032 -2584 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
3
is
:1212012011
VENDOR ClntaS SHIP Street Department
TO
3400 W. 131st Street
P. 0. Box 630803 Carmel, IN 46074
CONFIRMATION BLANKETC IIwlnRnati OH 45263-0803 PAYMENT TERMS (317) 733 -2001 FREIGHT
J?ff Kilgore
QUANTITY UNIT OF MEASURE DESCRIPTION I UNIT PRICE I EXTENSION
I
Account 0043 -565.01
1 Each laundry $4,500.00 $4,500.00
diki: t- l r Sub Total:. $4,500.00
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A Send Invoice To: �f J :f� r;�f
Street Department
3400 W. 131st Street
Carmel, IN 46074 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P
Carmel Street Department A NUMBER IS MADEAPARTOFTHEVOUCHERANDEVERYINVOICE ,500.00
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
y THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. 1 IJ /1 �I
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY I V` ).i k 1 i OA J.,,J�l_Li 4--__-
PURCHASE ORDER NUMBER MUST APPEAR ON ALL If
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 'TITLE k.: .0 C 1-
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. a
4 V
CLERK TREASURER
DOCUMENT CONTROL NO. 26256 OFFICE COPY