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INDIANA RETAIL TAX EXEMPT PAGE I 4 I
City o Carmel CERTIFICATE N0.0031201550020
City is �/2i �a PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �))7 I
35-60000972 v
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AIR
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
I C,4 —i G,s \ - i? 13<
VENDOR SHIP I 1.C,,„,c- -
TO vr-iCI 1 �) l
/-3Z
. -
F
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 �-S 4r ) J S 251
• u� , 1
•
4. , ,...4,.. '( .v,, ,
hill : CO
a �r.
Send Invoice To: "''+�/,,,/- � -', G� "
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
) Z-25 _3`'Z 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 CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROP AT NSU ICIENT TO PAY FOR THE ABOVE ORDER.
•'C 0.SHIPMENTS CANNOT BE ACCEPTED.
JJJ
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
q q CLERK-TREASURER
DOCUMENT CONTROL NO. 31671 OFFICE COPY
14.4/LOEF,ICE,DEP,OT11,1539.h '
12417 N. Meridian St.
Carmel, IN 46032
(317)571-1300
12/10/2013 13.4.7 3:40 PM
STR 534 REG3 TRN 1605 EMP 268612
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SALE crhbic s.w•>".+rr+w..drp
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Product ID Description Total
898782 STMP,PSTG,US,I
10 @ 46.00 460.00
You Pay 460.00E
347425 IIDPIINE,SHK,BI.K 19.995
Business Solutions Prc 19.99
:You4Pey 19.99S
. 422971 1.118E11•4 8293°400• .P•ali0995-0
Business Solutions Prc 6.35
You Pay 6.365
852982 DESKPAD,MNTH,2
4 @ 5.99 23.96
Business Solutions Prc 5.04
You.Pay 5.045
630758 .IIDifR.BNDR._2:D.. _�
2 @ 10.99 21 .98
Promotion
Reiail After Discounts 21 .98
Busiress Solutions Prc 22.980
You Pay . 21 .98S
544862 BNDR UD 2"DR W 10.99
+ c ,ice;
Promo{`onD a U i E b 5,".50 °c"
Retail After Discounts 5.49_n
Business Solutions Prc 11 .490
You Pay 6.49S
630758 MD DR BNDR 2"D
2 @ 10.99 21 .98
Promotion
Reid' I'A6171TD scounis.v.....21.-98a. r.A
ii a 1.<t �t�- JL7" Y.�h II
Business Sul ui'I nfis Pre '227980"p You Pas 21 ,985
544862 BNDR OD 2"DR W 10.99
Promotion -5.50
Retail After Discounts 5.49
Business Solutions Prc 11 .490
,. You<Pey 6.495
, 544862 'BNDR-UD•-22D0W.1
-Business Solutions Prc 11 .490
630758 UD DR BNDR 2"D 10.99
Promotion -5.50
Retail After Discounts 5.49
Business Solutions Prc 11 .490
. You<Pey • 6.495
630758 .11Dr nR BNf1R'2"0` _•._i0T99__"'.`_'
Promotion -- - - '• 5.50
Retail After Discounts 5.49
Business Solutions Prc 11 .490
You Pay 5.49S
Subtotal : 568.29
1 " ;1:-.:17:568.129t
Account Billlne 5267: 568.29