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PAGE INDIANA RETAIL TAX EXEMPT
City' i
of �/(.. 151114E4 CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT l���
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2554;' 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
I '1/10/751/3
40&-)66-22.66 -&,./&C.44r6(...„//a-I-10 (i.e' (iltAl jwiasj.Ditilem
VENDOR SHIP
TO
CONFIRMATION - BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
e_AA l 17 81 . -re c2
5600 . 6°
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Send Invoice To: : -
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
�%[ lf..�I', PAYMENT
�� l O .,6--y1 (-11 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
1--/ NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
re-e 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.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
U E�RETT}O.
DOCUMENT CONTROL NO. 31,6 U
CLERK-TREASURER
OFFICE COPY