HomeMy WebLinkAbout31252 E&B Paving City of f Carmel INDIANA RETAIL TAX EXEMPT PAGE
1111 \� CERTIFF CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SUPS,
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
-1Iel / 13
VENDOR t-i 6 i1'�rl SHIP
J TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
i I
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
X61:, U'\-G\a,u 1\ ` � U4 CUL\''13
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Send Invoice To: ,1 .- y (
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LAViAh) 1N yJoiLA 1 C� C
PLEASE INVOICE IN DUPLICATE I �-
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 CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION.SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• SHIP REPAID. -
•CO.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL t �
SHIPPING LABELS. �'I
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE I1";
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 312 52 CLERK-TREASURER
A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE