HomeMy WebLinkAbout32605 Monica HerzigNWI b11,14
City 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
S(i)115
VENDOR
r1o11(`klcl. I-I-of Z12
33'75; C. old r 1t y (v's 124
13ioorysivl34-0n) _N (--)-71-10S
SHIP
TO
CI ii8 or Ct rm u--E
C.x)■lmwhll" lat(Gtions
One Civic S
C Q r rYLe_ j, IN U 6903 0.
CONFIRMATION
BLANKET •
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Ja22 by) +144 YYIDnO ptr. (mahL1- Co)aof
Send Invoice To:
1a031g3sq063
PLEASE INVOICE IN DUPLICATE
ay) 06
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. 32605
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 THAT THERE IS AN UNOBLIGATED BALANCE IN •
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
ORDERED BY'/�J
PA:f
CLERK - TREASURER
OFFICE COPY
C ehmA" /Z� 1� ,t b