HomeMy WebLinkAbout32102 Republic Service of IndianaCi
of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
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THIS NUMBER MUST APPEAR ON INVOICES, AIR
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DERCRIPTION
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VENDOR
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CONFIRMATION
BLANKETS
CONTRACT
PAYMENT TERMS
FREIGHT
Ct 36
QUANTITY
UNIT OF
EASURE
DESCRIPTION
UNIT PRICE
EXTENSION
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Send Invoice To: p
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,a21,26 ,l3e00/4s v„er PPG)/
PLEASE INVOICE IN DUPLICATE,
DEPARTMENT
ACCOUNT
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SHIPPING INSTRUCTIONS
PROJECT
PROJECT ACCOUNT I AMOUNT
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 32102
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBYCE,RTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
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