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1 n 1 I'� CERTIFICATE NOO 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 0 U`�
35- 60000972
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 W.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE J DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: /S. SjE4)A/1- i it C' 1 c
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
A/P 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 THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. al p;
C.O.D. SHIPMENTS CANNOT BE ACCEPTED: l (fy,/�� I ___e•-- ,/7
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY e/,Yl��.�� 2 c.� zL
SHIPPING LABELS. I
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE (11.-714' 1-4 2/L: /t/ re 41V W-C, v,-(6/�--
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 27832 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
FI —P1 Indiana Planning and Zoning Law
Annotated
2011 Edition
Pre -Order Form
Pricing Price per unit Ordered t Payment
Orders placed by January 31, 2012 Any Customer
Book Only 25.00 f
Book CD containing searchable PDF of book 31.00
CD containing searchable PDF of book 25.00
Orders placed February 1, 2012 or after
APA IN Members:
Book Only 30.00
Book CD containing searchable PDF of book 36.00 r. 3 /Dg
CD Only containing searchable PDF of book 30.00
Books if ordering 10 or more 25 00
Non members:
Book Only 45 00`
Book CD containing searchable PDF of,book 51.00
CD Only containing searchable PDF of b`o'ok 45.00
Total: tog. 0D
Order information:
Name 0446 :(.1 /1.�
Organization C i 2 C4.em2L beprrrF a-v-,+t of Carnal tidily Seri) QASS
Address MeV ?C, ✓i 4.
City State, Zip fa4Q r t r Tr✓ thod3
Phone 3 /7 2/ dcjiv Email JSfe uar ftw encnE4, Sir
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Payment Information (circle one) n (�y�
Cash 4. Check/Money Ordef Purchase Order/ Bill Me U d!/ t
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Standard shipping will be by media mail. For faster shipping, contact Jamie Palmer.
Make checkslpayableto: APA Indiana
Return completed form by fax, mail, or email to:
Jamie L. Palmer
APA Indiana
PO Box 44804
Indianapolis, IN 46244
Voice: (317) 261 -3046
Fax: (317) 261 -3050
jlpalmer @iupui.edu
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