HomeMy WebLinkAbout31791 Walter P Mooreof Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 199i
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
3/711
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
VENDOR WO, gge r P none
e
1301 M(K•Inney,Suite 1100
Heusi- on, TX - 710111
CONFIRMATION
BLANKET
CONTRACT
SHIP C 13 C cl ((�� // 'l
TO 30 W /%in 5f 134;f 2Z0
<Arhlel,r/V 44032
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To
CNC
30 W MAih Sf. , Suii-e 22-0
(kr met,I i(/ 4 6032
&4\ \'\ohA - Co( e er\gI Ace rill) $241925,2` -
k4 expenses - Inrarrea ,h 54Un{
o{ P 0(Akum f ‘1‘1\ \\V‘ c& \•soh
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
02 4460807
SHIPPING INSTRUCTIONS
• 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.
ORDERED BY
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 AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUE ICIENT TO PAY FOR THE ABOVE ORDER.
IF
1
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TITLE NA.' !l /_ !/ (?/,( 9.4 11°
CLERK- TREASURER
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DOCUMENT CONTROL NO. 31791 A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE
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