51589 STAPLES BUSINESS ADVANTAGE •
INDIANA RETAIL TAX EXEMPT PAGE 1
CERTIFICATE NO 003120155 002 0Carmel _
City
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 1
35-60000972
ONE CMC SQUARE �._...,.,_..___. 1151589
j CARMEL,INDIAIIA 46022-2E54 i !THIS NUMBER MUST APPEAR ON INVOICES,A
II 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 I DATE REQUIRED 1 REQUISITION NO. VENDOR NO. DESCRIPTION
6/21/2018 06126/18 116869 ' 361528 IAO Office Supplies
Staples Business Advantage Administration Office
• Dept DET 2368 P.O.Box 83689 1411 E. 116th Street
VENDOR Chicago, IL 60696-3689 To P Carmel, IN 46032
CONFIRMATION i BLANKET I CONTRACT 'I PAYMENT TERMS I FREIGHT
I
I •
1
QUANTITY (UNIT OF MEASURE DESCRIPTION UNIT PRICE a EXTENSION
1.000 box Staples Nonstick Top Loading Sheet Protectors $10.1500 $ 10.15
1.000 carton Staples 1"Standard View Binder with D-rings white(12pk) $45.7900 $45.79
1.000 package Pilot FriXion ball Clicker Erasable Gel Ink Pens $8.0800 $8.08
3.000 package Avery 5-Tab Ready Index Dividers(6PK) $5.5400 $ 16.62
1.000 package 1"Felt Pads(16pk) $4.2900 $4.29
1.000 package Coffee Mate Creamer Packets $4.2900 $4.29
1.000 package Equal Sweetner Packets(100bx) $7.3900 $7.39
1.000 package Stanley Utility Knife $2.0100 $2.01
1.000 package Staples Calculator Tape(12pk) $ 10.4900 $ 10.49
1.000 package Staples OOPS Correction Tape(6pk) $6.7800 $6.78
1.000 package HP 05A Black Toner $66.5500 $66.55
1.000 package HP 36A Black Toner(2pk) $84.6600 $84.66
1.000 package Staples Sonix Gel Retractable Pens Red(12pk) $9.4900 $9.49
2.000 package Staples Sonix Gel Retractable Pens Blue(12pk) $9.4900 $18.98
1.000 case Copy Paper $36.2200 $36.22
GLAccount# 1125102-4230200
Send Invoice To:
$331.79
PLEASE INVOICE IN DUPLICATE
DEPARTMENT , ACCOUNT PROJECT IPROJECTACCOUNT 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 UNOBUGATED 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 Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 - ,p�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE DO
CLERK-TREASURER
DOCUMENT CONTROL NO. 51589 VENDOR COPY