31670 ID Ville EXEMPT
City o of Carmel CERTIFICATE RETAIL 03120155 002 0 PAGE I D 1
Carmel 111111
PURCHASE.ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT ) (I��,)
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AP
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
I
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
�C� Yn\� C.: -� Cr,Y v - 3
VENDOR
_5-3t A, Sir SHIP Q Ic
6cGI� l -1'8 AMT Z TO V J�
V C.c•1 mac` , =TS Al,°3?
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE
DESCRIPTION UNIT PRICE EXTENSION
03 00_,\ ,1_ JcIZO *Q\ (((il^1I_ U ( y-
iz
3.4 7
J`,
(3\C3<\ hql 'O-ve-^) L" �� �\_�A 1� .11'r
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17` .
'/ ii.Q 9 7
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04 �0, :
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•
tea:
Send Invoice To: � _ jiy
f
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT " PROJECT PROJECT ACCOUNT AMOUNT
1 ZDS _3_,Z PAYMENT
• A/P 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 CERTIFY7HAT THERE IS AN UNOBLIOATED BALANCE IN
•SHIP REPAID. THIS APPROPRI U SUFFICIENT TO PAY FOOlR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / �' i - 1
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL J
SHIPPING LRBELU.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT TH-ERETO.
DOCUMENT CONTROL NO. 31670 0 CLERK-TREASURER
OFFICE COPY