102452 SIMPLIFILE CityINDIANA RETAIL TAX EXEMPT Page 1 of 1
of IIariinie1
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102452
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AVP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING 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
1212112018 369043
SIMPLIFILE Clerk-Treasurer's Office
VENDOR 5072 NORTH 300 WEST SHIP 1 Civic Square
TO Carmel, IN 46032-
PROVO, UT 84604-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
32369
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1701 Fund: 101 General Fund
Account: 43-406.00
1 Each Recording Fees $1,500.00 $1,500.00
Sub Total $1,500.00
r � y
4 $ � s
Send Invoice To: � • �
Clerk-Treasurer's Office �k6
1 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT Q ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT $1,500.00
SHIPPING INSTRUCTIONS 'AVP 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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY :(1\/�
Jacob Quinn Ii
TITLE Deputy Clerk of City Business
CONTROL NO. 102452 CLERK-TREASURER