101476 G F C LEASING OH INDIANA RETAIL TAX EXEMPT Page 1 of 1
Chitof carnie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101476
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 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
3/8/2018 367166
G F C LEASING OH Dept of Community Service
VENDOR PO BOX 2290 SHIP 1 Civic Square
TO Carmel, IN 46032-
MADISON,WI 53701 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24039
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1192 Fund: 101 General Fund
Account: 43-530.04
1 Each Copier Rental $8,679.89 $8,679.89
Sub Total $8,679.89
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Send Invoice To: . t, "a . .;";',;';::A....,-,- ',.=.1 ,-:',.aa_s ;
Dept of Community Service
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1 Civic Square -', c `
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT � PROJECT ACCOUNT AMOUNT
PAYMENT $8,679.89
SHIPPING INSTRUCTIONS '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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL 77-)f -e--.2.5
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'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
ORDERED BY
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. i
Mike Hollibaugh James Crider
TITLE Director Administration
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CONTROL NO. 101476 CLERK-TREASURER