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11Lr l'�/ CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2-c2 0
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
41191+3 ,
N. Gil il\Le- I I5• ��
VENDOR It S W. J Sc\i 1 L, C A1- SHIP \--z- k-- Oc Er51 YI OS
S\vl'� ��. �JIO�� TO
Vs. 1 1-2N 4ia204:1
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
•
4400 •-int
Sir j d�I j! t .
iit '
Q m �
N.
IQ.: +, ,tit
.1`•
Send Invoice To: E 0 ,A_Qi.y,,A : Ve.. \.• . /, �(�/ L[� 20 poo •00
/ o � % 5J1�j1
21(-1410 2sgFs-- .
PLEASE INVOICE IN DUPLICATE
DEPARTMENT % ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
• 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 HEREBY CERJIEY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA ON:SUFFICIENT TO PAV,FOR'THE ABOVE ORDER.
•SHIP REPAID
/Tp PAY FOv_\1
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL 1 ` /
SHIPPING LABELS. ttt'�/�/�/'///'"'!!!///"��"„II,
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THHERETO.
25267 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY