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®� CERTIFICATE NO.03120X55 002 0
C/ PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 29210
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES.A/P
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
11/29/12 Contract 3C0657/4- AO/Maintenance JanitorialASetvices 2013
TINTED
Corvus Janitorial AO/Maintenance fl DEC 2012
VENDOR
Po.• -x G3(.0-.3s / SHIP
CA an n L , Q 452/40 TO f --
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
11 EA AO Office Monthly Cleaning Services Feb-Dec 2013 $175.00 $1,925.00
12 EA Maint Office Monthly Cleaning Services Jan-Dec 2013 $75.00 $900.00
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Send Invoice To
$2,825.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUFT I AMOUNT
1125-1-02-4350600-Cleaning Services - AO PAYMENT
1125-4-13-4350600-Cleaning Services - Maint • A/P VOUCHER CANNOT BEAPPROV:D FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS/N UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT A PAY FOR THE ABOVE ORDER.
•SHIP REPAID. }
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. Michael Klitzing - DK ■ `l c
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY g Li(Z,_,..Yi.CO.,` );,, \i 2-1)i
SHIPPING LABELS. 1
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE �` /Z {3 IF
i AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. /�
29210 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY /