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®f C arme i INDIANA RETAIL TAX EXEMPT
('�„/ ,Jjr Carmel. CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT q
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35-60000972 l( / ///
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
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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LI-6003 75 PLEASE INVOICE IN DUPLICATE ' !- -:'�
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DEPARTMENT ACCOUNT PROJECT PROJECT{ACCOUNT AMOUNT
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
FOR
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER'HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HERE=Y CERTIF(THAT EHERE IS ANrUNOBLIGATED BALANCE IN
THI ••P-6PRIATION-S' FICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. ///
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY / ' ^^''s
SHIPPING LABELS. i
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE O /99"1/ ( " '' d-t- l �A jaKV/S
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
Q CLERK-TREASURER
DOCUMENT CONTROL NO. 26599 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE