HomeMy WebLinkAbout32006 Mid America ElevatorCi
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
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
x. — 19 - / 3
Z'/ro ve /t)17 17 e , /, ,u s -1? 6'- 7) e.u>
VENDOR
r/` - r P `eA % E,eleetiaire L. G . , r
1( / 6: t >r 7420 -44.4..e.2. .
J/6 h �,) - 38.; �l
SHIP
TO
J
CONFIRMATION
BLANKET CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
02 �� �rrC4�W' /Z:k
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
775-
AMOUNT
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
TITLE
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 T aE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIp THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
X/T1
tJ
�j (� CLERK- TREASURER
DOCUMENT CONTROL NO. 6 +✓ A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE