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C i oy ®f Carmel CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT ,3c) Q O 0
35-60000972 1
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR SHIP
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
a h on 6ola,5 �, /46 ,1. /e _ 7q5,00
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Send Invoice To: ..1\,, 0-', , y ,
•
PLEASE INVOICE IN DUPLICATE
I DEPARTMENT 435 - 7o01-/ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1 C.i tO 1170 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.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
TE -ROP-F!'TION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. l/
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. 1 1-
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE , \ 1 I O I►L y
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. /
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 2 9 0 2 OFFICE COPY