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1\ J i J II I I,�. l CERTIFICATE TAI 0
003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT UWV /c
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP
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
a, rvew IGtin ps
VENDOR SHIP V` I vI eaun l
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
I
QUANTITY I UNIT OF MEASURE) DESCRIPTION UNIT PRICE 1 EXTENSION
6)1tpte CS s Sob 0 4 fit%
00 `IF SQL„
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Ca p a
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Send Invoice To: `a O �y( P
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
I RV) ►2 I 4 380D �0 PAP MEN EER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
\-9- Ill7 1 t4 Lit0 -3 O NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
I\ VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRU TIONS U I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APP P A ON SUFFI I O PAY F THE ABOVE ORDER.
SHIP REPAID. y 'l\WI/ I FI
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON'ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 6 0 3 5 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY