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PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT S / 55 7
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
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PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VENDOR E ; d e 13 Ail!y SHIP (!1
r Dux !�l t TO 30 W 44'17 5/J0/710220
/70220
Q,;a;)hi�l< //n 58502--1714 (4rMcI, T// WI03L
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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1 2013 �1 (cQUn- i/ / ;cry/ /(1 -Toy rip �; `1Sll. a ,
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Send Invoice To: ? ( n (!�
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(&1mH 314 g60/2
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
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COL 7 3'`1 LJ3d3 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 APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. B S%�•�V''-(�-P��.��J
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. i'• �� ,. - J
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY 111�/�(^'^/,�'-Q""A'A-
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SHIPPING LABELS. /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETTOO.
DOCUMENT CONTROL NO. 31557
CLERK-TREASURER
A.P.V. COPY-S SIGN AND RETURN TO CLERK'S OFFICE