HomeMy WebLinkAbout30305 Indiana Dept of Workforce Dvmt 0 INDIANA RETAIL TAX EXEMPT PAGE
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Carmel CERTIFICATE N0. 003120155 002 0
lL y' of ���°SW llllli PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 30305
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO. PACKING SUPS,
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
12/20/11 N/A 4(0500 Unemployment Claims
Indiana Department of Workforce Developement AO
VENDOR ID N �r1nTa AVE. STE. IU SHIP
IYl DI A rlAp01-1 S I H 9- �Da-�- TO I
nFC 9 92011
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS S"'% FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1 EA 2011 Unemployment Claims $27,690.00 $27,690.00
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Send Invoice To:
$27,690.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT 1 PROJECT 1 PROJECT ACCOUNT I AMOUNT
1125 -1- 4110000 -Full Time Regular PAYMENT
AM VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER I5 MADE A FART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWOR,I AFFIDAVIT ATTACHED
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE I5 /N UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TJ PAY FOR THE ABOVE ORDER.
SHIP REPAID.
•C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY Michael Klitzing DK C1M 217,1 11
PURCHASE ORDER NUMBER MUST APPEAR ON ALL 7
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS :945 TITLE 12- au L D I
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
30305 CLERK TREASURER P
DOCUMENT CONTROL NO. VENDOR COPY