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1\ llllll �111JJ/ LL CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT s--to
35- 60000972 ZS
ONE CIVIC SQUARE 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
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VENDOR SHIP e ?4 0C kinI V�Q0✓1 SO(�
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY IUNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
a i A -4
l i e Nett 9 .0
Send Invoice To
a m 2S 000. O"D
C�S
I..If
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
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 THERC-9S UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFI (JTTO F OR THE ABOVE' ORDER.
SHIP REPAID.
C.0.0. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
R
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THEERETO.
DOCUMENT CONTROL NO. 25810 0 CLERK- TREASURER
OFFICE COPY