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1111 I`\1/ CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 5/-592
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,ATP
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
VENDOR 1 fl(1; AAn ANoll ) ` oil rice I n(, SHIP C fZ C 1
Li- gill w ' Q6+h s ! To 3O W. /��ih St
2 ion 5/I Ile ,TN 46077 � �r mel,T N X6032
CONFIRMATION I BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE ti (DDESCRIPTION UNIT PRICE EXTENSION
I 'ii evv6`� 1� or ilO1or (our* j-1-Air5 21818.°4
OS---- . 0.!....... 4:1Ai-ta.,
p4
Nia`P.. is y�'42_ oQ ••••• 00 1��1
Send Invoice To: _j � �� (�5��
j it PLEASE INVOICE IN DUPLICATE
DEPARTMENT I` ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
-I 02 4'-k 6O877 PAYMENT
• AM 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 CERTIF`FTHAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER_
•SHIP REPAID. f _>
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY •-c-f'
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
LABELS, / i:i - /0
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE //I '/ . .�---\
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. - . ,-
DOCUMENT CONTROL NO. 315 42 CLERK-TREASURER
A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE