HomeMy WebLinkAbout25282 Clark Dietz PAGE INDIANA RETAIL TAX EXEMPT C LL ty o f C aimel CERTIFICATE NO.
003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2 c 2 0
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,MP
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
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VENDOR SC/co Ve stje& Cross\ JIQ ckq.900 SHIP_ 'JC-A--. Q.@-- Y�.9_.kr,OS
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CONFIRMATION BLANKET CONTRACT - PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: M 9 10 I 3�°DO op
qI9— so2S99D
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 SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. 1 / 1
•C O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY •
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELU. bi-, /'_jJ •
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE hi,
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO /
25282 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY