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City ®f C are 1 INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO.
0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �06ad
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
/- 9- /5 /- 1-/5 3S7?s'9J ' ..5l —re 4a/CE.-
)2 LIM 1 i c £ & ems &el-OK :ee 6o/f' 01„.b
VENDOR 0 s2 C;Y12 '/g SHIP /.2/22O ] /C /7/i,rc / le6L
TO
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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410
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Send Invoice To: � '
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PLEASE INVOICE IN DUPLICATED
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
/22 7 7 3s- a I PAYMENT
• NP 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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERT2 Y THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS AP�ROPR(ATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. I
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. CJ r
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY i
SHIPPING LABELS. < 1 � /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 604 /JUi)lr✓LlW -'C'
i
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 0 0 2 0 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY