26324 Service First Cleaning if� 0 INDIANA RETAIL TAX EXEMPT PAGE
I ®� \ ,a.r ei { F,+ii�CEFIATIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
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FEDERAL EXCISE TAX EXEMPT 26324
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SUPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12/18/2012
Service First Cleaning Street Department
VENDOR Payment Processing Center SHIP 3400 W. 131st Street
TO
10632 Grand Riviere Drive Carmel, IN 46074
Tampa, FL 33647 (317) 733-2001
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE{ DESCRIPTION UNIT PRICE EXTENSION
Account 0043-506.00
1 Each cleaning $5,200.00 $5,200:00
Sub Total: $5,200.00
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Send Invoice To: �� � �--� •
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Street Department
3400 W. 131st Street
Carmel, IN 46074-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Street Department PAYMENT $5,200.00
• NP 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 PRO FR SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAI/HE-E.IS•N UNOBLIGATED BALANCE IN
THIS APPROPRIATIO Mf Iw NT TO PAY FOR THE"'ROVE ORDER.
•SHIP REPAID. .�•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. 4 - ,4
ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ( a;,:i_ Al............1......\.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
26324 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY