HomeMy WebLinkAbout32114 Vine and BranchCi
of Carmel
' ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAfEXEMPT
CERTIFICATE NO. 003120155.002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
3,a//,/
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
'URCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
FREIGHT
DESCRIPTION
Ste. /S
" ij- /s
o/g906
12.3
D e
f fe_ E c
VENDOR
1A0E
%a l /t76
L e// 035
SHIP
TO
ge_ode_s4; 66 / 2 e /Lh
/074,26
69-19-14 j1 i./ 3s
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY • I UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
/3/0%'K6if» Gold' Club
/ 02/010 s• Cs,-,
e14-4M
se££YIIOoE
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
/ ,20`7
1./35-4' 9a
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. 32114
ORDEREDeBY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT /
• A/P 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 APP TION.SUFFICIENT TO PAY FOR THE ABOVE ORDER.
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