HomeMy WebLinkAbout32913 Jack Dohenyi
l ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
C®f nrmel
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35-60000972
PAGE
PURCHASE ORDER NUMBER
32813
THIS NUMBER MUST APPEAR ON INVOICES AP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
IOlIShs.
VENDOR
�0.CK Do ken./ .Connpo_ri.e.s
2R1 ker,y Coca+
p. 0. Box x (o 0'I
No {hv114e,
NAT- 9 $I lc1
SHIP
TO
Street Depnrlmen+
3'100 vv. 131$1 sfee-1-
westAeld, 1N tito014
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY I UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
'En31neer, ry
PLEASE INVOICE IN DUPLICATE
Por+able pipehne
Inspection System
LComerCX
See racc Doke^y
Compo�n e-.3Quok
N E 151,250=
2SO- %S09 00
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.
DOCUMENT CONTROL NO. 32913
ORDERED BY
TITLE
CLERK -TREASURER
OFFICE COPY
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.
• 1 HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIr ION SUFFICIENT TO PAY FOR THE ABOVE ORDER.