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l\ c 2tt iI CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
111444... y �a \��11// �ls �a FEDERAL EXCISE TAX EXEMPT('
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP
CARMEL, INDIANA' 460B2-2584 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 ryes beer t. („.„.5 l 57&.- ib SHIP '/b L,�' OI G /L i,2Q,
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE l DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
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6' rriA), T t I 0 <P INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
NP 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.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS PPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. r
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY E
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PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE f,L i1YtJ 1 1. 0-- 1 J--4. /j
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO 27847 A.P.V. COPY -SIGN AND RETURN TO CLERK'S OFFICE