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o f Carmel CERTIFICATE NO 003201 5 2 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2-to 33
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
`7'I to /13
Sunbelt Revltaas
I220 i 1115w1VII Rcl e,-1 oi, Cu
VENDOR SHIP l�Onl YrtN11 O[I G.1'-7Ln'11 �pt"
s„, ,) -Hu -1No3 TO 1.
Dine Civic S€.
Carrnt,l 270 '-Itoo33-
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Gtnuccrov ren—u,t Ca bit COUV voiftd -TY ATts + J>sIG^Distncr ewer-11 £ $3 (o'p ao
Ayr Di 1,0InL
Pr+vmD2llru.
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Send Invoice To: p4 �`=' �� -
1705/44 35gCO3
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 CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIF NT TO PAY FOR THE ABOVE ORDER.
• SHIP REPAID. �� V 1/ ] ,, _..
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. (l„j//0/�/JI{//�'�
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. ,,{,�7//� /J ///I /` _,t
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 CR TITLE P . Cr l ginl-4'1�.. /4-4 .. �r/C t7TI /r '�-TlLF�ie.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. - — V
2 6 8 3 3 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY
•