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•C of C lS�s r e 1 CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER i
1 FEDERAL EXCISE TAX EXEMPT
35-60000972 0
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
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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CONFIRMATION BLANKET CONTRACT u, PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRI ,(p -A UNIT PRICE i EXTENSION
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Send Invoice To: 17 5 Jr
PLEASE INVOICE IN DUPLICATE
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DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
0O" ,5 D ?j 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.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS AP"• IATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
1 SHIPPING LABELS. y
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945' TITLE �rr j r
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO 4,
DOCUMENT CONTROL NO. 258 C TREASURER 1
OFFICE COPY