HomeMy WebLinkAbout25293 Crossroad Engineers City � INDIANA RETAIL TAX EXEMPT PAGE
�°�� '}� (�� CERTIFICATE NO.003120155 002 0
CC.•/a I . li el PURCHASE ORDER NUMBER
\� FEDERAL EXCISE TAX EXEMPT 2c 2_ ' S
35-60000972
ONE\'IVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES.A
CARMEL, I `A A 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIP.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY coRRESaorIDENc
'RCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
\\\ 'A\1
/ENDOR C Sc--)V-D \AtQs5 SHIP UL?k 0 '(t∎Y1 e.S lI Os
)NFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
•
. S k
1
A.co C PR 424.t.. 11IN
�•�A31 tV
•Send Invoice To: g. G0 0tR� op
s , s- 1
•
a 2Al - 1o(
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS 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 • T ERE IS AN UNOBLIGATED BALANCE IN
•
SHIP REPAID. THIS APPROPRIATI9 1I � 0 PAY FOR THE•401(E ORDER.
•
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY it, / s•
/ /
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL 1 HIS RD U /04:14____.,,,,'
T O
THIS ORDER R ISSUED - -
. - GS
T IN COMPLIANCE WITH CHAPTER 99,ACTS 19J5 • TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 5 2 9 3 CLERK-TREASURER
DOCUMENT CONTROL NO y VENDOR COPY 7