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lnl S. ty CERTIFICATE N0O 003120155 155 00 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35- 60000972 7 c-(, 3-
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 REOUISITION VENDOR NO. DESCRIPTION
VENDOR C >'oss i o 0a, En�' t'rLQ6. (S SHIP 0 A.. C ELAQ I•LQ�VI ✓IS
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE 1 DESCRIPTION UNIT PRICE EXTENSION
ASS 2R
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*7' •A
a
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Send Invoice To: VI r� l� `q 2 COO °-a
W> -40(
PLEASE INVOICE IN DUPLICATE 20 7
DEPARTMENT ACCOUNT I 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 1 HEREBY CER TMf NERE 15 AN LJNOBLIGATED BALANCE
THIS APPROPRIATION >J F ICIE.i PAY FOR TH ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE s
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 5 8 1 7 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY