51687 REPUBLIC SERVICES #761 `� INDIANA RETAIL TAX EXEMPT PAGE 1
� CERTIFICATE NO.003120155 002 0
City
it o PURCHASE ORDER NUMBER
��/ FEDERAL EXCISE TAX EXEMPT 51687
35-60000972
011E CIVIC SQUARE
CARMEL,41,DtAI°f ,:.+^_0"32-2ES THIS
NUMBER
R,DELII
VERY MEMO,PACKING I
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
7/11/2018 07/16/18 17069 358593 Dumpster rental for Park Maint.Office Usage
Republic Services#761 Parks Maintenance
P O Box 9001099 1427 E. 116th Street ATTN: Courtney
VENDOR Louisville, KY 40290-1099 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1.000 each Haul fee $309.0000 $309.00
1.000 each Delivery fee $ 120.0000 $ 120.00
GLAccount#1125401-4350400
•
Send Invoice To:
$429.00
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 Michael Allen
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER ^ ��
DOCUMENT CONTROL NO. 51687 VENDOR COPY