101681 SUPERION, LLC INDIANA RETAIL TAX EXEMPT Page 1 of 1
C1tTof Carnal NUMBER
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMB
FEDERAL EXCISE TAX EXEMPT 101681
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION &ae5/23/2018 372128
SUPERION, LLC Clerk-Treasurer's Office
VENDOR BANK OF AMERICA SHIP 1 Civic Square
12709 COLLECTION CENTER DRIVE TO Carmel, IN 46032-
CHICAGO, IL 60693-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
26155
QUANTITY . UNIT OF MEASURE : : . : DESCRIPTION : _ UNIT PRICE EXTENSION
Department: 1701 Fund: 101 General Fund
Account: 43-515.02
1- Each ANNUAL MAINTENANCE FEE $22,270.22 $22,270.22
Sub Total $22,270.22
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Send Invoice To: .. ' 1�t� - r
Clerk-Treasurer's:Office \ .
1 Civic Square '. " . ' ,
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Carmel, IN 46032- p,.r
PLEASE INVOICE IN DUPLICATE 0
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DEPARTMENT . ACCOUNT . PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $22,270.22
SHIPPING INSTRUCTIONS •
NP 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
`THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 19451/��:1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dianne Walthall
TITLE Director of Financial Reporting
CONTROL NO. 101681 CLERK-TREASURER