26057 Republic Services o 11.. INDIANA RETAIL TAX EXEMPT PAGE
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1 II \u 2It e JI CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
y �Y 11 FEDERAL EXCISE TAX 213057
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
21212012
Republic Services Carmel. Police Department
VENDOR SHIP 3 Civic Square
TO
832 Lansdale Avenue Carmel, IN 411032
Indianapolis, IN 48202 (317)5712559
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
I Account 43.501.01
12 Each trash collodion $112.00 $1,344.00
Sub Total: $1,344.00
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Send Invoice To:
Cannel Police Department 3
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 48032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. QS PAYMENT 51,344•00
J NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROP R SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY 7 •T f ERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT d ICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
•C.D. D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
of SHIPPING LABELS. A p, PAIICe
_THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 O CLERK— TREASURER•
DOCUMENT CONTROL NO. OFFICE COPY