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�it_ ;, ®� ��� (�� RTIFICATE NO.003120155 002 0 t
1�// �v PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT f
35-60000972 `�'6 q(-1/-
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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lD S i W(2 -01�ZCC.� SHIP I36P 1 cTi A- LUIS 1, yrrio J
VENDOR �1 (0/J f" CI V LG 44/1.70
-� )1;fk�l A°190 4--1 4 Z7df TO (2 .,.IM L L.J .1. lO (it&6 Z.,
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: �> _ k "
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. PLEASE INVOICE IN DUPLICATE ,
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
A$r!'ii IPV)c TRATi ON J 1 s- `"5 so 0 PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
' ` •�. SHIPPING INSTRUCTIONS �; �
i ''1THIS APPROPRIAT ON- iCIENT TO PAY FORT E ABOVE ORDER.
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REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY L J
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ' L/
•THIS ORDER R ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 0
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
® CLERK-TREASURER
DOCUMENT CONTROL NO. d A.P.V. COPY-SIGN AND RETURN TO:CLERK'S OFFICE