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103076 (REVISED) jir INDIANA RETAIL TAX EXEMPT Page 1 of 1 ofCarmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 103076 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDEN CE‘0\* FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 8/21/2019 357831 Equipment Maintenance-12/1/2019-11/30/2020 ,' SERVICE EXPRESS INC ICS VENDOR DEPT 6306 SHIP 31 1st Avenue N.W. PO BOX 30516 TO Carmel,IN 46032- LANSING,MI 48909- Timothy Renick (317)571-2576 PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 39120 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1115 Fund: 101 General Fund Account: 43-515.01 1 Each Annual Equipment Maintenance $7,147.53 $7,147.53 Sub Total $7,147.53 c). -------'-'"•. .\\\/7,4>. , F: TiT ,/1 - S;t- It :1 I:Irci- it. ) Send Invoice To: g ICS Aggee "e t�.2211¢3: - Timothy Renick 31 1st Avenue N.W. Carmel,IN 46032- (317)571-2576 PLEASE INVOICE IN DUPLICATE DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT PAYMENT $7,147.53 SHIPPING INSTRUCTIONS *AN 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 Timothy Renick James Crider TITLE Director Administration CONTROL NO. 103076 CLERK-TREASURER