HomeMy WebLinkAbout25263 Crossroad Engineers Cif ® n Camel INDIANA RETAIL TAX 0155 00 PAGE
,fLr CERTIFICATE TAI TAX EXEMPT PT 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT -7��!_
35-60000972 C. �(1
ONE CIVIC SQUARE
THIS NUMBER MUST APPEAR ON INVOICES,MP
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
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VENDOR \Je - 0 EVS.IAU 1/"1 0S
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE I DESCRIPTION I UNIT PRICE EXTENSION
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Send Invoice To: l -e. f _ .1107' 1�SI O00- c70
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
e PAYMENT
• ANP 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 CERTIFY AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT •'SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
I •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
L 5 L O 3 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY