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INDIANA RETAIL TAX EXEMPT PAGE Cit) o Carmel CERTIFICATE NO.003120155 002 0
PURCHASE HASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT /J/ C/f 3
35-60000972 / J 7
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
VENDOR Ameri (t), 5+rqd Nr ppoird TO O fi(I-II'I�� / •
1260 Shedei nJ S144tn
InJinn4140s ,jw 46251 (erhi eIIIA/ 46052
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 AAcii liOnd Arrh'I-Ie (4 4rAl /eh9; neerih9 1 ii MOP
5e 'If( (e S for the NO ro) er-J-
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Yr : 6 z
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Send Invoice To: C R ,�
30 W nt n 5-1 .
' mr0 ,1.v 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1 U2 LF,4 60 co-Li 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.6THAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•CO.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
THISORDLRISSU. A
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 7:)7":4 /f
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 31543 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE