51999 REPUBLIC SERVICES #761 NL XEMPT PAGE 1
PURCHASE ORDER NUMBER
City CERTIFICATEINDIAA NO.RETAI003120TAXE155 002 0
• ,e
el FEDERAL EXCISE TAX EXEMPT 51999
35-60000972
Old;CIVIC SQUARE
CARMEL,,!f•ILD[=•fiA-3832-2ESL THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER,DELIVERY MEMO,PACKING SUPS,
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
10/3/2018 10/07/18 17809 358593 2018-2019 Trash Services for Central Park West Commons
Republic Services#761 Parks Maintenance
P 0 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 I EXTENSION
5.000 each Monthly trash and recycle service at West Commons lx per $ 110.0000 $550.00
week from November 2018- March 2019
7.000 each Monthly trash and recycle service at West Commons 3x per $261.6600 $1,831.62
week from April 2019-October 2019
GLAccount#1125401-4350101
Send Invoice To:
$2,381.62
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 ANDSUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 51999 VENDOR COPY