31647 CDW Government 0 Carmel
INDIANA RETAIL TAX EXEMPT PAGE
City ®of � � CERTIFICATE NO.003120155 002 0
City y PURCHASE ORDER NUMBER _1
FEDERAL EXCISE TAX EXEMPT
35-60000972 31647
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 r 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
12/1612013 J Page Tablet
CDW Government, Inc. Carmel Communications
VENDOR SHIP Terry Crockett
75 Remittance Drive, Suite 1515 TO 3 Civic Square
Chicago, IL 60675-1515 Carmel, IN 46032
(3171571-2567
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS 1 FREIGHT
I
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 44-632.01
1 Each Startech USB 3 to VGA Video Adapter 2577700 $64.26 $64.26
2 Each Samsung S24C200BL 23.61N 2913010 $152.21 $304.42
1 Each'?+;;'Microsoft VGA Adapt Win8/8Pro Conner 3065494 $34.43 $34.43
1 Each MMirosoft Surface Type Cover Blk 3065490?'( 4 i- $111.60 • $111.60
1 Each 'Microsoft Surface Pro 2 Dock Station 3140482 . - - $171.70 $171.70
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1 Each Microsoft Surface Pro 2 128 GB i trop 3147590" A !l $958.11 $958.11
1 Each Logi Wrls Mk320 Opt Combo �660U8 •.• ' ' "" •nf bl, $28.79 $28.79
1 Each Ken 10"Soft Carry Case 263t481�. .• S $17.00 $17.00
2 Each 4Y monitor Rplc Plan$1051,$ 99/3Y,OEM 2954501 A •. $12.78 $25.56
1 Each 3Y Tablet repair w/ADH$90.-$t 000DOP 3165068 jai '".• ' $234.84 $234.84
/` t • Sub Total: $1,950.71
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Send Invoice To. Quote#DXCH763 _V' ((.
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City of Cannel
Terry Crockett
3 Civic Square ,
Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
d a If ribs t PAYMENT $1,950.71
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
N NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY _ 7,-
��'/
/� v
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Director
AND ACTS AMENDATORY THEREOF AND SUPPLEMENTTHERETO.
`. t CLERK-TREASURER
1
DOCUMENT CONTROL NO. 3164 7 OFFICE COPY