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I' Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2S-2-CO
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.
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 TOIPe�`�- pr E� ' k vLQA�f Yl
1 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
212- -TO?
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PLEASE INVOICE IN DUPLICATE
•
DEPARTMENT - ACCOUNT ! PROJECT 1 ,-- 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 ATTr HERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIoN•SIUFFICIENTTO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. d '
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY c
SHIPPING LABELS. /
-
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ',
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25264 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY