HomeMy WebLinkAbout25296 Crossroad Engineers City' J, 11 //�y� INDIANA RETAIL TAX EXEMPT PAGE
n ® ' Carmel°,,}�r /� CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
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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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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS 1 FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION•
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• PLEASE INVOICE IN DUPLICATE 2 � l— — (o7�9.Sj•oo
i DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• NP 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 APPRORIA SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.,
•COD.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
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SHIPPING LABELS. -
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETTO. _
25296 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY -