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C JI� armej CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
b•' .i I,; FEDERAL EXCISE TAX EXEMPT (40 C.)
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, All
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 2 L I lrA WC11 w es a Dr 1
1 J Z TO one Clvks- SclLicre, 12p�o
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CONHRMAiFON BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE I DESCRIPTION UNIT PRICE EXTENSION
ac Co`p e c e,ense 1,��5c�,
moo1Cc 4, VU`iRc7,1 4 Z\nJ
(\Our cape /pr,ni /Sec 4( l
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Send Invoice To g
lack /U3s3oo`-I CoP +e,f I
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER I5 MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS 1 HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
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 6407 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY