4800204034.pdf
PDF 24 KB Posted
- Attached to
- NE|4800204034
- Contract number
- 4800204034
- Issued by
- Nebraska
About this file
This is a Purchase Order issued by the University of Nebraska Medical Center (UNMC), a state institution under the Board of Regents of the University of Nebraska. The order is placed with Amazon Capital Services Inc., vendor number 234098, located in Seattle, Washington. The purchase order is dated 05/20/2026 with order number 4800204034, and is governed by the Standard Terms of Purchase established by the University of Nebraska unless superseded by an existing agreement between the vendor and the Board of Regents.
The purchase order is for one (1) unit of CMS 1500 Claim Forms containing 500 sheets (new), with material number B0CLB5R7RQ and reference ARIBA_P2P. The unit cost is $24.80, resulting in a total purchase order amount of $24.80. Delivery is scheduled for 05/27/2026 to UNMC General Supply at 601 South Saddle Creek Road, Omaha, Nebraska 68106, with an unloading point at UDA. The terms of sale are Net 30 with F.O.B. Destination, freight prepaid. The University's tax-exempt number is 05-8905401, and payment is to be remitted to the UNMC Accounts Payable office at 985040 Nebraska Medical Center, Omaha, Nebraska 68198-5040.
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Text version
Your ref.:ARIBA_P2P
001 1 EA CMS 1500 Claim Forms - 500 Sheets | New 24.80 24.80
Your material number: B0CLB5R7RQ
Vendor: 234098
AMAZON CAPITAL SERVICES INC
PO BOX 81207
SEATTLE WA 98108-1207
MATERIAL
NUMBERLN# QTY ORD UNIT ITEM DESCRIPTION UNIT COST TOTAL COST
Please Deliver To:
UNMC General Supply General Supply 601 South Saddle Creek Rd Omaha NE 68106
Delivery Date: 05/27/2026
DESTINATION
F.O.B.
INSTRUCTIONS AND CONDITIONS
1. Please acknowledge acceptance of this within 10 days of the order 3. Nebraska State Treasury warrants without exchange must be date. accepted in payment of all claims against the University.
2. Mark and ship packages as shown in rectangle in upper right 4. All shipments are to be made F.O.B. destination, freight prepaid corner unless indicated. unless otherwise indicated on this form.
Unloading Point: UDA
4800204034 / 05/20/2026 Contact Person/Telephone
Dept Buyer / 402-472-2126
Tax Exempt #05-8905401 UNMC Billing Address:
University of Nebraska Medical Center Accounts Payable 985040 Nebraska Medical Center Omaha, NE 68198-5040
Page 1 / 1
TO ASSURE PROMPT PAYMENT THE PURCHASE ORDER NUMBER MUST APPEAR
ON ALL PACKAGES, INVOICES, AND RELATED DOCUMENTS. PACKING SLIPS
MUST ACCOMPANY ALL SHIPMENTS.
P.O. TOTAL 24.80
QUOTE NUMBER
Purchasing Authority:
Net 30
TERMS OF SALE
This purchase order is governed by the Standard Terms of Purchase at http://www.nebraska.edu/terms-of-purchase, unless an agreement referenced in the item description is effective between the vendor and the Board of Regents of the University of Nebraska, in which case such agreement shall govern.
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