101492 HOOSIER PORTABLE RESTROOMS INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of Inrinnie1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDERnNUMBER
FEDERAL EXCISE TAX EXEMPT 101492
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
311312018 354857 TRAILER UNIT&CLEANING FOR ICE RINK-FEBRUARY 2018
HOOSIER PORTABLE RESTROOMS INC Community Relations
VENDOR 2201 E 99TH ST • SHIP 1 Civic Square
TO Carmel, IN 46032-
INDIANAPOLIS, IN 46280-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24160
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1203 Fund: 101 General Fund
Account: 43-590.03
1 Each UNIT AND HANDWASHING STATION FOR FEBRUARY 2018 $9,000.00 $9,000.00
Sub Total $9,000.00
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Send Invoice To: -, ... �. ,--, 31-1,: ;,::121,.:, i"
Community Relations m x
1 Civic Square �'`"` � .a,,. "-'°
Carmel, IN 46032- p i F ..,--6:,4,I. a.,�=
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $9,000.00
'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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 c�
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /f j (�, di i. 1-.4,.--k_ 1 '�.� \
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Nancy Heck James Crider \�
TITLE Director Administration .
CONTROL NO. 101492 CLERK-TREASURER J