36587 Staples Business Advantage INDIANA RETAIL TAX EXEMPT PAGE 1
Citof Carmel CERTIFICATE N0.003 20155 002 0
T7 of j•il 11 PURCHASE ORDER NUMBER
1 FEDERAL EXCISE TAX EXEMPT 36587
35-60000972
_Cjl•14_ THIS NUMBER MUST APPEAR ON INVOICES,AIP
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1/28/2014 02(01/14 442 ✓6.isGO Ice Melt Pallet
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
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1.000 each Pallet of ice melt $445.50 $445.50
GLAccount# 1125401-4236500
1.000 each 758320 - Neat Office Scanner $ 170.99 $ 170.99
GLAccount# 1125413-4230200
Send Invoice To:
$ 616.49
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT Iii jE PROJECT PROJECT ACCOUNT I AMOUNT
RE Ly I V .: PAYMENT
• 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 PROPER SWORN
SHIPPING INSTRUCTIONS JAN 28 7014 AFFIDAVIT ATTACHED.
. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. ` SUFFICIENT TO PAY FOR THE ABOVE ORDER.
EL
. C.O.D SHIPMENTS CANNOT BE ACCEPTED. . ._ ._. ����
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS, ORDERED BY Courtney Schlaegel 2 f'1Cit. 'a'al,L- /c�%'/`/
�.fic
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
CLERK-TREASURER
DOCUMENT CONTROL NO. 36587 VENDOR COP`