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City ®f Carmel CERTIFICATE NO.003120155 002 0
V .,x-,; PURCHASE ORDER�NUMBER'`t
FEDERAL EXCISE TAX EXEMPT lV/„ac-J
35-60000972
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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VENDOR SHIP ‘���-- c� 1 ,
TO Q_�
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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4:01/10:A„...„,sicv,---_, ccw.H... - , ,
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Send Invoice To: . 6 °°
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211-14Ko2JoD
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
• PAYMENT .:
• • A/P 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 HEREBY CERTIFWHAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID
THIS APPROPRI TON$U.EI6IENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY \
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL \
SHIPPING LABELU. \ atrn e
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE -' °1 : v[/w` Th
,AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY