52141 STAPLES BUSNESS ADVANTAGE INDIANA RETAIL TAX EXEMPT PAGE 1
rmel
y CERTIFICATE NO.003120155 002 0
Ci , of PURCHASE ORDER NUMBER
C`"" FEDERAL EXCISE TAX EXEMPT
52141
35-60000972
C*IE C('/iC SQUARE
CARMEL.`rl ala l:;`=Cy2"H S`" THIS
VOUCHER,DELIAVERYMEMO,PACKING SLIUST APPEAR ON PS,
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
11/8/2018 11/13/18 18129 361528 AO Office Supplies
Staples Business Advantage Administration Office
Dept DET 2368 P.O. Box 83689 1411 E. 116th Street
VENDOR Chicago, IL 60696-3689 SHIP
HP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each Staples Monitor Stand-Item#643687 $ 17.4200 $17.42
1.000 each CE505D Printer Toner 2pk#332849 $ 108.7100 $ 108.71
2.000 each Softsoaf Hand Soap 1 Gal#792739 $ 11.7500 $23.50
3.000 each Staples Sonix Gel Pens- Red, Blue, and Black $9.4900 $28.47
1.000 each Pilot Frixon Ball Clicker Erasable Asst.#938560 $8.0800 $8.08
2.000 each Pilot Frixon Ball Clicker Erasable RD,BL,BK#147442 $8.9900 $ 17.98
1.000 each 2019 Desk Calendar refill#24329979 $ 14.2900 $ 14.29
2.000 each Scotch Adhesive Roller#393634 $2.5900 $5.18
1.000 each Copy Paper#135848 $36.2200 $36.22
GLAccount#1125102-4230200
Send Invoice To:
$259.85
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT
• MP 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 Dawn Koepper
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER I
DOCUMENT CONTROL NO. 52141 VENDOR COPY