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� CERTT IFICICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT ill,STS—.
35-60000972
ONE CIVIC SQUARE
CARMEL,INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS ANDANYCORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR
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CONFIRMATION BLANK Ey CONTRACT fes/ PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
Sisc ILb,Hi2' £/P ?/
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
217 73016 / PAYMENT
• A/P 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 C IFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS THLS•APP RATION SUFFICIENT T PAY FOR THE ABOVE ORDER.
• SHIP PREPAID.
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY a v/r
.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL / / /
SHIPPING LABELS. it )51-)&11-7E'er""v•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. `
CLERK-TREASURER ���`
)OCUMENT CONTROL NO. 34558