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C0 INDIANA RETAIL TAX EXEMPT o�
it' 7 of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
3ti5--/5
35-60000972
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
DEPARTMENT ACCOUNT /� PROJECT PROJECT ACCOUNT AMOUNT
L�� •1 • .. ,,` � 1 l.,(-�
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
SHIPPING INSTRUCTIONS THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• SHIP PREPAID. X
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER ��`
DOCUMENT CONTROL NO. 3 4 5 7 5 ,` ,‘N