HomeMy WebLinkAbout32921 Clark Dietz+I , Y «o'. - arms
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
3.2921
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
4 12-211 �5
VENDOR
C 1c-r k DI et , Inc.
'act OO Keysior e Cross+r,q
St-6i -e clop J
1.ncii ar,apol■s, 1 N
4&20':f
SHIP
TO
pep-!. of- Er.51r,eerin9
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
`Send Invoice To:
Loco Ptojee-t : I\ -05
INOOT roes tr 100(002-
Cor,s- h-uch0' 1rpeC+kon
P,,k e / Pedes +an
- j-,'G,11 o-, 10l��' S'1Y-ee+
om 0 ?t..c h Roc.d ` h?
7 1 1„ , o i s S tr've -e*
PLEASE INVOICE IN DUPLICATE
t�3,I(.06.40
13`x, 5 900- 1,.1yb2220
3y �33.28 2o2- +-13509100
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
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.
DOCUMENT CONTROL NO. 32921
ORDERED BY
TITLE
AMOUNT
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 TI, IAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION FFICIENT-TO PAY FOR THE ABOVE ORDER.
CLERK - TREASURER
OFFICE COPY. •