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Lit or '-,q!, '(.l 1 el CERTIFICATE NO 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2 W 52.3
. 35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
5/23113
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
• QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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0 (-,:-.7 „.. 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.
..,. • NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS `''4. • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPRO°•IATIO�.SUFFICIENT TO RAY FOR THE ABOVE ORDER.'!'
• SHIP REPAID. - -
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /at,- . '
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ', ORDERED BY ' / f • 4
SHIPPING LABELS. } \ "
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �.,/,J ��
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. '.
2 CLERK-TREASURER ;r
DOCUMENT CONTROL NO.` OFFICE COPY