37913 Indiana Dept Workforce DevelopmentCity 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
37913
IBIS NUMBER MUS I APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED)
REQUISITION NO.
VENDOR NO.
DESCRIPTION
12/18/2014
12/22/14
3779
Unemployment Claims
Indiana Dept. Workforce Develo
10 N Senate Ave. 5E106
VENDOR Indianapolis, IN 46204 -2277
SHIP
TO
Administration Office
1411 E. 116th Street
Carmel, IN 46032
CONFIRMATION
nI ANKEI
ON I RAGI
PAYMENT IERMS
FREIGH
QUAN II TY I UNIT OF MEASURE DESCRIPI ION UNIT PRICE EXTENSION
1.000 each Unemployment Claims
Send Invoice To:
GLAccount// 1125101- 4110000
PLEASE INVOICE IN DUPLICATE
$ 20,280.0000 $ 20,280.00
$ 20,280.00
DEPAR I MEN I I ACCOUNT I 'HOJIiCI
SHIPPING INSTRUCTIONS
• SI HP REPAID.
C.O an SHIPMEN 1 S CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON AI.I. SHIPPING L AIII`J S.
• I HIS ORDER 15511ED IN COMM IANCC WI TI I CI Al' I ER 99 ACTS 1945
AND ACTS AMENDA IORY I HEREON' AND SUPPLIEMLN I I HERETO
DOCUMENT CONTROL NO. 37913
PROJECT ACCOUNT
AMOUNT
PAYMENT
AIP 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.
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY
TITLE
CLERK - TREASURER
•LL :P= -0i Eli CUPY
Dawn Koepper
CD'a . J4 :_rpk I z l 1 th y.