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ofCC INDIANA RETAIL TAX EXEMPT�� ��� � �Y CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
37e 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 ANDANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR // 5'S-0 6eD � � S S1-4- /6 oww. SHIP
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CONFIRMATION BLANKET CONTRACT APPAYMENT TERMS FREIGHT
JO e-1 36
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
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61-12-otil, _. --7--) woss
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
/.,2--o7? ii3 --e l y0z) 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 C_EXIFY THAT THERE IS,AN UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS THIS_AP,PROP YATION SUFFICIE T TO PAY FOR THE ABOVE ORDER.
• SHIP PREPAID.
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. b�q/21 ! �v// 9
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE e-�, 4, 'v
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURERil) Nqt.
DOCUMENT CONTROL NO. 34585 11