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\\ �1 ®� Carmel CERTIFICATE N0.003120155 002 0 PURCHASE ORDER NUMBER
�1 r/ \1/ �a FEDERAL 5-00 0972 EXEMPT 2 c 29C
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AP
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
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: -MI--�/ll107 ^�
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PLEASE INVOICE IN DUPLICATE .60 t
DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT -
• AP 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 HEIWERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS PP. PR.TION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL /�
SHIPPING LABELS., / �_ ^ l'
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1995 TITLE �1� /�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 5 2 9 5 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY