51520 ACE-PAK PRODUCTS, INC INDIANA RETAIL TAX EXEMPT PAGE 1
City
CERTIFICATE NO.003120155 002 0
IL a � `s 1 � PURCHASE ORDER NUMBER
`l✓ *�,.r' L 1 LL 1�✓ FEDERAL EXCISE TAX EXEMPT 51520
35-60000972
ONE cmc SQUARE
CARMEL,:IDtAtIA 4 c,32-2ES. THIS NUMBER MUST APPEAR ON INVOICES,
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
6/7/2018 06/11/18 16691 366118 Outdoor park cleaning supplies
Ace-Pak Products Inc. Parks Maintenance
12602 Double Eagle Drive 1427 E. 116th Street ATTN: Courtney
VENDOR Carmel, IN 46033 SHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION I UNIT PRICE EXTENSION
10.000 each 60060260-Rags in a box $ 13.4900 $ 134.90
6.000 each 15604349-56 gallon black trash liners $ 18.4900 $ 110.94
10.000 each 63001043F-large nitrile gloves $6.8900 $68.90
10.000 each 63001044F-extra large nitrile gloves $6.8900 $68.90
GLAccount#1125401-4238900
Send Invoice To:
$383.64
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT 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 AND SUPPLEMENT THERETO. TITLE \\\"��aa••
CLERK-TREASURER
DOCUMENT CONTROL NO. 51520 VENDOR COPY