53690 STAPLES BUSINESS ADVANTAGE INDIANA RETAIL TAX EXEMPT PAGE 1
el
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a CERTIFICATE NO.003120155 002 0
City
of
��r PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 53690
35-60000972
ONE CUIC SQUARE
CARMEL.U [=+,IIA a [-C $= APPEARTHIS NUMBER MUST S,A/P
VOU HER,DEUVE YMEMO,PACKING ESLIPS,
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
10/21/2019 10/20/19 21704 361528 Office Supplies for Parks&Natural Resource
Staples Business Advantage Parks Maintenance
Dept DET 2368 P.O. Box 83689 1427 E. 116th Street ATTN: Courtney
VENDOR Chicago, IL 60696-3689 TOHIP Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
2.000 each 135848-Staples copy paper $34.480 $68.96
1.000 each 887354-cartridge 111 magenta toner $ 178.190 $ 178.19
1.000 each 887355-cartridge 111 yellow toner $ 178.190 $ 178.19
1.000 each 887356-cartridge 111 cyan toner $ 178.190 $178.19
1.000 each 620332-501A black toner $ 133.330 $ 133.33
1.000 each 2658108-Canon RP-108 Ink cartridge/photo paper $37.290 $37.29
1.000 each 504308-Swingline stapler $2.800 $2.80
2.000 each 108985-Swingline staples $ 1.620 $3.24
1.000 each 329493-Westcott KleenEarth scissors 2 pk $7.310 $7.31
1.000 each 480118-Staples push pins $2.110 $2.11
4.000 each 518337-Cork bulletin board 3'x1' $36.970 $ 147.88
2.000 each 876991 -ghent cork board 18"x24" $36.690 $73.38
1.000 each 125328-Sharpie black fine point 12pk $4.740 $4.74
1.000 each 490349- Red dual tip sharpie markers 12pk $ 14.040 $ 14.04
1.000 each 24339943-Staples mouse pad with gel wrist rest $7.690 $7.69
Send Invoice To:
$ 1,309.10
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I 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 UNOBUGATED 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. 53690 VENDOR COPY
INDIANA RETAIL TAX EXEMPT PAGE 2
CERTIFICATE NO.003120155 002 0
1 ';Y of a r PURCHASE ORDER NUMBER
����,�/// X L{ 35-60000972
ONE AMC SQUARE
CARIsT_L !NO[ H4 G C32-2ES4 THIS NUMBER MUST APPEAR ON INVOICES,A/P
Y ` VOUCHER,DELIVERY MEMO,PACKING SUPS,
'I 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
10/21/2019 10/20/19 21704 Office Supplies for Parks&Natural Resource
Staples Business Advantage Parks Maintenance
Dept DET 2368 P.O. Box 83689 1427 E. 116th Street ATTN: Courtney
VENDOR Chicago, IL 60696-3689 SHIP Carmel, IN 46032
•
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
1.000 each 397983-5"x*"notepads 6pk $5.510 $5.51
1.000 each 809816-8.5"x11.75"narrow ruled white notepad 12pk $ 12.660 $ 12.66
1.000 each 2623359-DAX wood poster frame black $ 14.250 $ 14.25
3.000 each 198949-Victory light plastic poster frame 24"x30" $ 17.490 $52.47
2.000 each 1683118-ASUS 19"LED monitor $76.290 $ 152.58
1.000 each 2637373-Simple designs floor lamp $34.290 $34.29
GLAccount#1125413-4230200
Send Invoice To:
$ 1,309.10
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I 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. 53690 VENDOR COPY