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HomeMy WebLinkAboutHasler - Purchase OrderAPPROVED D•Y THE STATE BOARD OF ACCOUNTS FOR THE CITY OF JEFFERSONVILLE- PURCHASE ORDER Form 98 (Rev. 1998) CITY OF JEFFERSONVILLE PAGE: 1 INDIANA RETAIL TAX EXEMPT 500 QUARTERMASTER CT, STE 300 CERTIFICATE NO. 003120953-001-0 JEFFERSONVILLE IN 47130- PHONE: 812-285-6422 1139 PURCHASE ORDER NO FEDERAL EXCISE TAX EXEMPT FAX: 812-285-6426 . 35-6001057 THIS NUMBER MUST APPEAR ON INVOICES, A/P VOUCHER DELIVERY MEMO PACKING SLIPS TO REQNUM 1139 SHIPPING LABELS AND ANY CORRESPONDENCE. SHIP TO: City Council 500 Quartermaster Ct. Jeffersonville IN 47130 ATTN: DATE DEPARTMENT SHIP TO ARRIVE BY September 6, 2007 CITY COUNCIL APPROPRIATION gUANTITY UNIT DESCRIPTION UNIT PRICE AMOUNT NUMBER 101013327.000 1.0 EA RASTER WJ150 MAIL MACHINE 4995.00 4995.00 101013327.000 0.0 HASLER WJWP10 SCALE 0.00 0.00 101013327.000 1.0 EA ANNUAL MAINTENANCE ON EQUIPMENT 650.00 650.00 SHIPPING CHARGES: 0.00 SHIP VIA TOTAL 5645.00 SHIPPING INSTRUCTIONS PAYMENT 'SHIP PREPAID ' A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS ' C.O.D. SHIPMENTS CANNOT BE ACCEPTED MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE `PURCHASE ORDER NUMBER MUST APPEAR ON ALL PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING LABELS. ' 1 HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN • THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. AND ACTS AMENDATORY THEREOF AND SUPPLEMENTAL THERETO. ORDERED BY TITLE VENDOR # 5094 CENTRAL BUSINESS SYSTEMS P.O. BOX 4450 LEXINGTON KY 40544 OFFICE COPY FORM AEB 530 y I SUGGEST THIS ORDER 6E PLACE ~~ CITY ATTN. OF DATE =` ~~~~~~~ REQUEST TO PURCHASE e ~f ~ _ d ,~ 'L`t-•k--`2.."` SHIP TO '`"' ~~.~ ~ / , ZIP ATTN. ~Qf =~ ~ ~~~ I QUANTITY ~ ( f EACH DOZEN GR~~S, ETC.; DESCRIPTION - FURNISH AS COMPLETE AS POSSIBLE -NAME OF ITEM, SIZE, COLOR, NAME OF COMPANY, CATALOG NUMBER, CATALOG PAGE, MANUFACTURER, PART I NUMBER,E TC. ~ UNIT j PRICE ~ I AMOUNT ~y ~ C. 'ta..-- ,, .-, ~, _. , -~_ ,~.~ > -- ~~r~a SHIP TO ARRIVE BY i TOTAL .~ SUBMITTED BY_ _ 11 t t ~` FOR OFFICE USE ONLY ORDER FROM ............ ~..,.~. __ DEPA~F~j~~ ~...., APPROVED BY ~ ~ } GC JJ REMARKS: APPROVED ORIGINATOR