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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
32%32
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.
I
DESCRIPTION
212q 115
VENDOR
DLL
151 Eosi NAo Io d s+► -eer
4L 9,2
SHIP
TO
Dep +.
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
• EXTENSION
Send invoice To:
eerlr\3
r
Pr di e ct 1 5 - 03 Corn -tick cAte 2 /20111
1I16 s1-N -ee+ Hanel Dell
Par k.w c>,•/ IZ A 2 De Si. y1
F+ -c;I p1 -mctse
312,885
od
PLEASE INVOICE IN DUPLICATE
44• q(4,285 2 o2 RL1y l0O.5oO
use P.a.3∎905
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
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 THE / PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERT�%THAT THERE IS AN ��UN, OBLIGATED BALANCE IN
THIS APPROPRIA//T.ION•SUFFICIENT TO N/�Y FOR THE ABOVE ORDER.
CLERK- TREASURER
If DOCUMENT CONTROL NO. 326 32 OFFICE COPY