HomeMy WebLinkAbout26386 West Group City I Ca CERTIFICATE NO 00312015MO20 PAGE
IF 111111 PURCHASE ORDER NUMBER
a PAK �067 a F /A 10 FEDERAL 5X 0 0972 EXEMPT n3 rj
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
(2107/ r
VENDOR 71---A eid 4 SHIP
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE l,._,_,_ I ESCRIPTION�/ UNIT PRICE EXTENSION
,o
i f 1
D 80� 'D5, off
.1:• 0$7.10'•••••
11�
M O
Send Invoice To: OQ O
�J�rri�l�J -10
PLEASE INVOICE IN DUPLICATE
DEPARTMENT L/ ACCOUNT PROJECT 1 PROJECT ACCOUNT 1 q� p� 6
AMOUNT
�y .4. 7CIO
'6/D PAYMENT /'TU O(Q
UU 9 a i1� APVOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
KX /VN_/ C/ I /_y_/( a GJ 0 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 UNr: TED BALANCE IN
THIS,! B8R0PRMi1BN -6UEE PAY F• THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY E /y��
SHIPPING LABELS. �'iJ� emote"
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE l •w{
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
26386 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY