HomeMy WebLinkAbout36479 ICC Business f INDIANA RETAIL TAX EXEMPT PAGE 1
City of C L11.,, rine CERTIFICATE NO.003120155 002 0 36479
11 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
Oil= .Idl:- =C.tU--_
_Ol,trl 1:DN.:: c--'2-, THIS NUMBER MUST APPEAR ON INVOICES,ALP
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
12/17/2013 12/22/13 174 /NG000 Printer Toners
ICC Business Products Administration Office
3164 N. Shadeland Ave 1411 E. 116th Street
VENDOR Indianapolis, IN To P Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
5.000 each HP 1505 Toner $ 54.95 $274.75
1.000 each HP 1300X Toner $ 39.75 $39.75
1.000 each HP 1320X $47.25 $47.25
1.000 each HP 1020X $ 30.59 $30.59
GLAccount# 1125102-4230200
•
Send Invoice To:
$392.34
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT 1 PROJECT PROJECT ACCOUNT 1 AMOUNT
FAT?/-'^ r . PAYMENT
i
NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
(1 •1 i PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS j;!- 1 % r U1.7 ' AFFIDAVIT ATTACHED.
•
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
.
COD SHIPMENTS CANNOT BE ACCEPTED. 1'=- +
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Dawn Koepper � ,tikot '�t4 /Z/I '7II3
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 F-"�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36479 VENDOR COPY