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CERTIFICATE NO. O. 003120155 002 0
PURCHASE ORDER NUMBER
D G T) J A n FEDERAL 35-60000972 EXEMPT 6 3 g 5
ONE CIVIC SQUARE /T 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 C SHIP
3 7Z .d1- .c� cu m_ TO
3
rvV il(aoc/
CONFIRMATION BLANKET CONTRACT PAYMENT- FREIGHT
QUANTITY UNIT OF MEASURE I` "DESCRIPT ON
UNIT PRICE EXTENSION
1
A' ,,i, "Aitilled. zo 3, Odd .De
e g d etai g fit 6
120 os. S /o�a i
vim'• 124 1
At -4
Send Invoice To: .0 �-o f
6901/ /I
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
k W ilgb 13O- I /DOO b PAYMENT 3 DOO Da
T AP 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:7
SHIPPING INSTRUCTIONS I HEREBY CE a THATTHER ••BLIGATED: LANCE IN
ROP'ATIO T TO PAY FOR THE.. :OVE ORDER.
SHIP REPAID.p
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. V
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE elHAirlii
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 26385 OFFICE COPY