37904 Paperless Business SystemsCity of Carmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PAGE 1
PURCHASE ORDER NUMBER
37904
THIS NUMBER MUS F APPEAR ON INVOICES, NP
VOUCHER. DELIVERY MEMO, PACKING SLIPS,
SHIPPING VJ3ELS AND ANY CORRESPONDENCE
PURCHASE 0001911 DATE I DATE REQUIRED
REQUISITION NO.
VIENDOR NO.
DESCRIPTION
12/16/2014
12/20/14
3767
Additional User License - eRequester
Paperless Business Systems Inc
1417 Fourth Avenue 4th Floor
VENDOR Seattle, WA 98101
SHIP
TO
Administration Office
1411 E. 116th Street
Carmel, IN 46032
CONFIRMATION
IIL INKI I
CON IRACI
PAYMENT TERMS
FREIGII I
QUANTITY UNIT OF MEASURE I DESCRIPI ION
1.000
Send Invoice To:
UNIT PRICE EXTENSION
each Supplemental eRequester License Fees - 5 additional $ 720.0000 $ 720.00
06-- 1-3563v0
PLEASE INVOICE IN DUPLICATE
$ 720.00
UEPAR rM1N I
ACCOUNT
PR0JII CT
PROJECI ACCOUNI I AMOUNT
0e-1F-355000
SHIPPING INSTRUCTIONS
• 5111P R13PAFU.
. C 0 U SI OPMEN IS CANNO I BE ACCEP TED.
PURCHASE ORDER NUMBER MUST APPUIH ON ALT. SI IIPPINO I A131_I S-
11115 ORDER ISSUED IN COMPLIANCE W I U I CI IAP I ER 99, AC I S 1915
AND ACTS AMENDATORY I HEREOF AND SLIPPLEMEN I I I IERE 10.
PAYMENT
AA] VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P D. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
AFFIDAVIT ATTACHED.
HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SUFFICIEN 110 PAY FOR THE ABOVE ORDER.
ORDERED BY
TITLE
CLERK- TREASURER
DOCUMENT CONTROL NO. 37904 ` LNL tte COPY
Dawn Koepper
, 2-17i.1 V