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1 CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT OP 7 5"
35- 60000972
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 1
i At d 1 00
VENDOR /p2 83/0 FQI/j(e SHIP
TO
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
OUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION
I luau t& 41'2E29 CO i na. 5
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Send Invoice To: 1� �O R 9 O f
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6,4„1 _,0 1/6 050
PLEASE INVOICE IN DUPLICATE /47 I, 3 j
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
/2 e 5 re PAYMENT
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 P a ER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY H E AN UNOBLIGATEOBALANCE IN
THIS APPROPRIATI T TO PAY FOR T ABOVE ORDER.
SHIP REPAID. CIEN
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
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PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. i /j A
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE yv
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
V CLERK- TREASURER
1 DOCUMENT CONTROL NO.'2 3 52 OFFICE COPY