52225 UFB CARDMEMBER SERVICES ERTIFICATE O.0 PAGE INDIANA RETAIL TAX EXEMPT PA
City
o Carmel Tm�CFEDERAL EXCISE TAX'EXEMPT0 i PURCHASE ORDER NUMBER —
35-60000972 € ' 52225
ONE•GMC:SQUAR£
CARMEL,IF D A*A 4€032.2E34 THIS NUMBER MUST APPEAR ON INVOICES,AIP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE I DATE REQUIRED '1, REQUISITION NO. VENDOR NO, DESCRIPTION
mow.,_.
12/7/2018 112/12/18 1;18360 371208 •
i Membership Renewal
(Illinois Association of Park D)' BEING PAID BY UFB VISA Administration Office
211 East Monroe Street CARDMEMBERSERVICES 1411 E.116th Street
VENDOR Springfield,IL 62701-1186 PO BOX 790408 To P Carmel,IN 46032
ST LOUIS,MO 63179-0408
.CONFIRMATION .BLANKET ( CONTRACT PAYMENT TERMS ., FREIGHT
i
QUANTITY I UNIT OF MEASURE r _ DESCRIPTION • UNIT PRICEI EXTENSION
1.000 each 2019 Membership Renewal for COO $244.0000 $244.00
GLAccountit 1125101-4355300
Send Invoice To:
$244.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT 1
AMO
_
ACCOUNT- - - �PROJECT , � PROJECT ACCOUNT —�
„„..__„ UNT
PAYMENT
• AP 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
• SI-UP 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
DOCUMENT CONTROL NO. XX-7718 VENDOR COPY
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