50736 REPUBLIC SERVICES #761 INDIANA RETAIL TAX EXEMPT I
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CERTIFICATE NO.003120155 002 0
FEDERAL EXCISE TAX EXEMPT
0 _J PURCHASE ORDER NUMBER
2ity
50736
35.60000972
.. . .OI •CMViC;SQITARE ...
GAitI7MEl iP liltdA:46032-25 4. THIS NUMBER MUST APPEAR ON INVOICES,MP
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
1/5/2018 01/09/18 14934 358593 2018 Outdoor Parks Trash Service
Republic Services#761 Parks Maintenance
P O Box 9001099 1427 E.116th Street ATTN:Courtney
VENDOR Louisville,KY 40290-1099 TSHOIP Carmel, IN 46032
CONFIRMATION BLANKET I CONTRACT PAYMENT TERMS I FREIGHT w
QUANTITY 1 UNIT OF MEASURE 1 ___._._____....................:......_.._.._._.... DESCRIPTION I, UNIT PRICE 1 EXTENSION
12.000 each 2018 monthly trash service $ 150.0000 $1,800.00
GLAccount#1125401-4350101
Send Invoice To:
. $1,800.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1 �. ACCOUNT _ PROJECT _ PROJECTACCOUNT j AMOUNT ...........—
P&TAL
_..,.I'_&TA► 1T
• AM 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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBUGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
▪ C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Courtney Weintraut
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 / IC)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 50736 VENDOR COPY