51766 GRAINGER INC INDIANA RETAIL TAX EXEMPT I}PAGE 1
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' CERTIFICATE NO.003120155 002 0- I
: e. FEDERAL EXCISE TAX EXEMPT PURCHASE ORDER NUMBER
51766 _
35-60000972
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flEL.,ITID.IANA t,SO32 2.!S4 THIS NUMBER MUST APPEAR ON INVOICES,/VP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
i FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED r REQUISITION NO. VENDOR NO. DESCRIPTION
7/31/2018 08/04/18 j 17270 1370440 1 Replacement Baby Changing Stations(ADA)
I MCC-West
Grainger Inc. 1235 Central Park Drive East
VENDOR SHIP Carmel, IN 46032
Dept.804491322 TO
Palatine, IL 60038
CONFIRMATION! BLANKET CONTRACT I PAYMENT TERMSI FREIGHT
I
QUANTITY j UNIT OF MEASURE DESCRIPTION I UNIT PRICE 1 EXTENSION
2.000 _ each Model#KB200-00(Cream)KOALA KARE ADA model $215.5900 $431.18
GLAccount#1125419-4235000
Send Invoice To:
$431.18
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
EAYMENT
• Al?VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART OF THE VOUCHER ANb 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
CLERK-TREASURER
DOCUMENT CONTROL NO. 51766 VENDOR COPY V
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