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City Carmel Y���� INDIANA RETAIL TAX EXEMPT PAGE 1 c 1
CERT NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2-L1+2,3
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR L3 _1.•� ��N 9 5511"c- Z.J-' SHIP CC
l ,l TO Jrv� C",
TO
�c1.c .1 i -1 ,..270 412,,A
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION
1 e51�� 1-ee� X
3,6 3
400 oP a
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Send Invoice To: ��I r� UU
1 1rJJJ�11J
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
)Z- PAYMENT
AIP 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 1 HEREBY CERTIFY THAT FHERE SAN UNGBLIGATED BALANCE IN
THIS APP PRIATION SUFFICIENT TO PAY FOF THE ABOVE ORDER.
CHIP REPAID.
/V G /9.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. /.j//�'. if e•
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE I 1 OP
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 6 4 2 3 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY