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1tY 0 4 Carmel 1 1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
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j ONE CIVIC SQUARE THIS 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 FREIGHT ,
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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3 clomp o-1-4 G pQ( +Ie o 41-a e-l -eci . 4101,00 x 3 = 43 e3,00
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Send Invoice To: boo CI ia5 1LIG/1-e1/4.( �� (`
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT . PROJECT PROJECT ACCOUNT AMOUNT
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•NUMBERIS MADE NA PART OF THE OVOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS ION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. I I
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED, ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. //V rI A•l'
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE y
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
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'::'CLERK-TREASURER
I DOCUMENT CONTROL NO. 31729 '-oFFICE`co y