50963 HOOSIER PORTABLE RESTROMMS INC A jINDIANA RETAIL TAX EXEMPT PAGE 1
! City of.Carme I CERTIFICATE N0.003720155 002 0
PURCHASE ORDER NUMBER
V FEDERAL EXCISE TAX EXEMPT I
50963
35-60000972
-ONE'CNlC•SflilAlftE: �._..__.._._..._._. __.. .... 1 I
C,4RL1E•L,.IMDtANii 2584 {THIS NUMBER MUST APPEAR ON INVOICES,AIP
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
1 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
'
PURCHASE ORDER DATE I DATE REQUIRED REQUISITION NO. I VENDOR NO. I DESCRIPTION
2/23/2018 '02/21/18 115384 354857 I Portalet restrooms for parks 2018
1
Hoosier Portable Restrooms Inc Parks Maintenance
2201 E 99th Street 1427 E. 116th Street ATTN:Courtney
SHIP
VENDOR Indianapolis,IN 46280 So Carmel, IN 46032
CONFIRMATION-I BLANKET 1 CONTRACT i PAYMENT TE RMS I FREIGHT
QUANTITY _I UNIT OF MEASURE DESCRIPTION I UNIT PRICE [ EXTENSION
22.000 each Rental/cleaning of EAU enhanced portalet for Carey Grove $40.0000 $880.00
Park(mid-May thru mid-October-22weeks)
GLAccount#1125403-4350400
22.000 each Rental/cleaning of EAU enhanced portalet for Hazel Landing $40.0000 $880.00
(mid-May thru mid-October-22weeks)
GLAccount#11254104350400
22.000 each Rental/cleaning of EAU enhanced portalet for Meadowlark $40.0000 $880.00
Park(mid-May thru mid-October-22weeks)
GLAccount#1125414-4350400
Send Invoice To:
$2,640.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1ACCOUNT PROJECT 1 PROJECT ACCOUNT AMOUNT
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
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED 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
AND ACTS AMENDATORY THEREOF ANDSUPPLEMENT THERETO. TITLE .
CLERK-TREASURER
DOCUMENT CONTROL NO. 50963 VENDOR COPY