29282 Staples CityINDIANA RETAIL TAX EXEMPT PAGE
(� CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
X11 Carmel. FEDERAL EXCISE TAX EXEMPT 29282
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
12/17/12 N/A 36/528' AO Office Sup lies
Staples A0 [
Dept- PET 23(0g SHIP DEC 1 7 2012
VENDOR
Po. `ox 8)36g9 TO
CONFIRMATION BLANKET ONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
See attached requisition for complete breakdown $8,345.44 $8,345.44 rs"
aci-l-I vcz- ('hcvi �
•
•
�`I o.L 3c
Send Invoice To
$a,3 '
PLEASE INVOICE IN DUPLICATE
,5E,y-75•q(/
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUI•T AMOUNT
1125-1-02-4230200-Office Supplies 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 SWORD AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS/N UNDBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT ID PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY Michael Klitzing - DKl, ��. --ir \ 1Z��71'I
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE , i�/ It- 'Lo R-
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
29282 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY