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PURCHASE ORDER NUMBER
. FEDERAL EXCISE TAX EXEMPT 'Ali B 30
35-60000972 v` (/ .Jll
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. ■ DESCRIPTION
93 (13i1 0.
Wvl)kl Ins 'BYDt'hids CI vC C4rpy ��JJ
VENDOR 31 S. 124n(ie LIIu., Road SHIP ,gyp . c4 Cornrrtin Ht) IC((Q-t1OY1S
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CG (YV�r I, r TO OV)( C11V1( S .
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE . EXTENSION
?e( A act i+1Diat Styv, us 1ifu.1114 0 (I
C`o rrty 0 c i- pq . 0.5_2013
welo5l (31 h f MGilo �ntr { OO�� man&yrY(.,-
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Send Invoice To: �• �f, - ili 4317 .
.,� ' 3 22S DU
1203 �L4 c/Oo j 1 )1
- PLEASE INVOICE'IN DUPLICATE
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 CP 'FY THAT THERE IS AN UNODLIGATED BALANCE IN
THIS APPR• IA •,:SUFFICIENT TO PAY F•R THE ABOVE ORDER.
•SHIP REPAID.
•CO.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY at • /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL . -
SHIPPING LABELS. •-_.\
/ s
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ' TITLE i (_-.-
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
26830 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY