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\\ i�� \�/ CERTIFICATE NO.003120155 002 0 PURCHASE"ORDER GNUMBER
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FEDERAL EXCISE TAX EXEMPT 2 IpS z Q
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
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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 9250 1.10 r4m ✓t Lis-t)VI.0 fl.J'r . SHIP
COm MUVI X41 Af'7(mS 1�PrJ4-.
Ind.a via polis, Zn.7 Uu240 TO
One Civic SCb�f.,•a
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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5 12,y°0. °°
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Send Invoice To: ,0.. '=`' b'” �j-ir pp
1203f '-1359003 -W Jr
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PLEASE INVOICE IN DUPLICATE .
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT.
PAYMENT
• AIP 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 THATTHERE IS AN UNOBLIGATE BALANCE IN 1;
•SHIP REPAID.
THIS APPROPRIATION SUFFICIENT T•PAY FORT - :•V .a-DER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY l_�AALdL Al / it / ' .. •
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL Ir ,
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE p / 11 ,/
pi), . •/ 1%)�)7 F . 'sr vn.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. U - x-``44'••
2 6 8 2 8 CLERK-TREASURER
DOCUMENT CONTROL NO. V O 2O OFFICE COPY