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INDIANA RETAIL TAX EXEMPT
C C
y o f a 1 M.e CERTIFICATE NO.003120155 002 0
PuRCHASE ORDER NUMEER
FEDERAL EXCISE TAX EXEMPT 36069
35-60000972
ONE CIVIC SQUARE IRIS NUMBER MUST APPEAR ON INVOICES.Al'
VOUCHER, DELIVERY MEMO. PACKiN, SUPS.
CARMEL, INDIANA 46032-2554
SHIPPING LABELS AND ANY CORRESPONDENDE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEI - 1997
PURCHASE ORDER DATE!
DATE REGUIPH.)-1- REOliSITION NC). ■
VENDOR NO. DESCRIPTION
8/14/13
I MO01097 J o2251,40 I Ballast & Light Bulbs
Batteries Plus Maintenance
PO. aox SHIP AUG 1 4 2013
VENDOR mmtpv\el 469(4
TO
; R.ArIKET CONTRACT PAYMENT TERMS FREIGHT
CUANTITY LL‘,1,JEALURE
3 UNIT PRICE EXTENSION
EA BAL10321 - 350w Metal Halide Ballasts $59.99 $179.97
4 EA MTH10090 - 350w Metal Halide Bulbs $47.99 $191.96
12 EA HAL11256 - 60 par 30 $6.99 $83.88
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Send Invoice To:
$455.81
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT
PROJECT PROJECT ACCOUNT I
AMOUNT
1125-4-01-4238900-Cleaning & Maintenance Supplies PAYMENT
AIR VOUCHER CANNOT RE APPROViD FOR PAYMENT UNLESS THE P.0
NUMBER.IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER.Sv,,OHN ArroAvir
SHIPPING INSTRUCTIONS HEREBY CERTIFY THAT THERE:IS IN UNOBI.IC:ATED BALANCE IN
SHIP REPAID THIS APPROPRIA1 ION SUFFICIENT tD PAY FOR HE ABOVE ORDER.
•
• C.0.0 SHIP!,,,,,,,,C.:ANNOT RE ACCEPT EC: Todd Snyder - DK
ORDERED BY
PURCHASE ORDER NUMBER mus'IA PPEAR CS ALL
SHIPPING LABELS.
! • THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER R FE,ACTS:945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
O.
36069 CLERK-TREASuRER _ •
DOCUMENT CONTROL NO.