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of C°�rme l CERTIFICATE NO.003120155 002 0
1i CVL li PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �JO3
35-60000972 p�
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
i0,55- 69" /)r "C/42-//
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VENDOR /�l/ iU �O ' 4.Q/016 SHIP /2/070 x.S/7,//etc P�
,5/725, _, a1-4/0 E/, _.. ---/-) 4(,033
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT,
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: -4 -
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PLEASE INVOICE IN DUPLICATE 17� b
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DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
/0207 1/3 - S°yJ°6 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.
SHIPPING INSTRUCTIONS • I HH ETNTFHERTD ALA
TIS REBY APPROPRIATIOCERIFY TN,,/S FFICIENT E IS TO AN PAY UNOBLIGA FOR THE E DA BB NCE ORD INE ER.
•SHIP REPAID. / v//
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. . . ,. • .✓
•PURCHASE ORDER NUMBER MUST APPEAR.ON ALL ORDERED BY
SHIPPING LABELU. / 'r
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 .U 23 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY