HomeMy WebLinkAbout32936 Upper White River Membership DuesC‘iiiir of Carmel
. ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584 1
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
32q?ia
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 NC
DESCRIPTION
51Slls
VENDOR
wK+e R,ver Pll,nnce
1052 wood I CI, yon Ave.
if CI can es_ poi IN, INI
Lito203
SHIP
TO
Dep +. OF En9i•'+eer,✓tiC
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE!
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
Er511-;Pe✓Iri
n
PLEASE INVOICE IN DUPLICATE
2019 Upper w41 {e
12:Iv Membcrsk;p,
i)ue S
2o15 2e5T ono. 1 Iv1H -,
Pr05 rar n Dues
•
OD
hl•TG : 10T 000
,2.200 - Rt- S0R O0
Use P. O. 3'2 -(p2 -
DEPARTMENT
ACCOUNT.
PROJECT
PROJECT ACCOUNT
SHIPPING INSTRUCTIONS
• - SHIP REPAID.
. COD. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER S9, ACTS 1965
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.'
ORDERED BY
TITLE
CLERK - TREASURER
DOCUMENT CONTROL NO. 32936 OFFICE COPY
AMOUNT
PAYMENT
• Ary VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY TH THERE IS AN UNDBLIGATED BALANCE IN
THIS APPROPRIATIOI9 UFFF1GIENT TO PAY F9R THE ABOVE ORDER.
•