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31695 L-Com Clay/(��y J,��,e (//�y� INDIANA RETAIL TAX EXEMPT PAGE o Carmel -CERTIFICATE NO.003120155 002 0 \�/ IIILLL u \1/ �L 1�la PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 31695 ' 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 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 2124/2014 PS2 Keybdlmouse to USB converters L -Com Global Connectivity . Carmel Communication Center VENDOR SHIP 31 1st Ave NW TO P.O. Box 55758 Cannel, IN 46032 . Boston, MA 022054758 (317)571-2586 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 42-370.00 10 Each USB-A to PS/2 MD6F KBD/MSE TL-U219-000R $18.38 $183.80 ( Sub Total: $183.80 • . ©O• } � ,r 0/� u1 •• a till M -4 1 \till‘scgL... W ...+4 Niologi Send Invoice To: .: v O�°ilp/a/O,A , , Cannel Communication Center � iJJJ1�1�j� 31 1st Ave NW Cannel, IN 46032- PLEASE INVOICE IN DUPLICATE (7/---DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1115 Communications PAYMENT $183.80 \ • 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 THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. QA p •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 11 L,i'/l A4--( •PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. / / ��/ �- e ///1 / •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE v D e♦" /9M Lie. /i/%if%L(i9(..- AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. f L q CLERK-TREASURER DOCUMENT CONTROL NO. 316 9 5 OFFICE COPY .