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City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102807
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
4/16/2019 371456
ANNE ESSEX Clerk-Treasurer's Office
VENDOR C/O C-T OFFICE SHIP 1 Civic Square
TO Carmel, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
35518
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1701 Fund: 101 General Fund
Account: 41-280.00
1 Each TUITION REIMBURSEMENT $1,556.83 $1,556.83
Sub Total $1,556.83
1444
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Send Invoice To:
Clerk-Treasurer's Office
1 Civic SquareotAy
Carmel, IN 46032- Pakl.
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT J PROJECT ACCOUNT AMOUNT
PAYMENT $1,556.83
SHIPPING INSTRUCTIONS 'Nip 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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 a(Afr4"44411-1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Dianne Walthall
TITLE Director of Financial Reporting
CONTROL NO. 1 02807 CLERK-TREASURER