HomeMy WebLinkAbout36472 Indiana Department Workforce City f INDIANA RETAIL TAX EXEMPT PAGE 1
lOL, ^ rm.^ I - CERTIFICATE NO.003120155 002 0 36472
11 cliff C Il PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
::HE x:1:1:; S:JII_:_
CL WEL.UI`IL{h_(^:. :cc_ THIS NUMBER MUST APPEAR ON INVOICES,NP
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 12/21/13 159 I'+65oo Unemployment claims
Indiana Dept.Workforce Develo Administration Office
10 N Senate Ave. SE106 1411 E. 116th Street
VENDOR Indianapolis, IN 46204-2277 So P Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE] DESCRIPTION [ UNIT PRICE EXTENSION
$ 1.00 each Unemployment claims 30,420.000 $ 30,420.00
GLAccount# 1125101-4110000
Send Invoice To:
$30,420.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT__._ I PROJECT I PROJECT ACCOUNT I AMOUNT
I ° 37 l PAYMENT
rl t ` tl r 7(.1 I • AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
I PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. _ SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.O.D SHIPMENTS CANNOT BE ACCEPTED, / 1
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Michael Klitzing / )2µ,y hu1occ., /Z)/ 'i) j
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /"
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36472 VENDOR COPY