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1 CERTIFICCATE NO. 003120 PT 0
PURCHASE ORDER NUMBER
C epa in all 4190 FEDERAL 5X 0 0972 EXEMPT As-?2 3
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
VENDOR a�^`G4 1 i h SHIP
in j����Ket- A4K.Ya'r l 4 Wes- a/eXITO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE l DESCRIPTION UNIT PRICE EXTENSION
Al
P i i gek.Gar'o �I�elleg 10-
e :2_ i atum(L6 taa) ch 3 ryt"
5
0 'i 9 Is.
1 TY O n 1
t ,1
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
9 J 11 gU 1 /3o 'YDQ.0TJ PAYMENT ii So2 O6
w��� t/ 1_ NP 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 APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
i
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY f'
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. I
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1965 TITLE ,•1" 0l �A/id1-�,
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
2 5 9 8 3 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY
1