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1st July 2013 Cust#0105000
DOUGLAS C HANEY
CITY OF CARMEL ,�I `r
CARMEL CITY ATTORNEY
1 CIVIC SQ t
CARMEL IN 46032-2584 Your
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2013 Indiana Legal Directory, Official Directory of the Indiana State Bar Association
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City o Carmel CERTIFICATE NO.003120155 002 0 Jl PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
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
0 TO
VENDOR - ." ,GFe . , "t�. SHIP
;7g r1j
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
'j ,[1' 411? ' �9L1v C� PAYMENT
O s A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
A. VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. f / •t'-
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �/`^� "�-� __ �.r? • �r",..{1....
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 j 3 3 9 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
$ 43 - �o
ON A COUNT�OFAPPRJF�IATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
1 hereby certify that the attached invoice(s), or
3 3
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except --- ------ - -- --------------
20a
.................--.-........---..--.. --....... .. .... .....................-.. ........_ ......- ....----.....------ --
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund