20011 Indiana Restaurant and Lodging Association City¢¢,,��,,,, of //�j` INDIANA RETAIL TAX EXEMPT PAGE I
o Carmel .CERTIFICATE N0.003120155 002 0
\��11./// y y �a T11//2 �L 1l PURCHASE ORDER NUMBER
1 FEDERAL EXCISE TAX EXEMPT 300 U r' ('
35-60000972 300 P
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
If �q �/ iy �i :i, •
/ /-(� SHIP ) n
VENDOR ltn,,, S R1•e✓' ap 7v K'13 SD TO /c2/o7O 13 cxXS/l�1/21L Pl'/«y
-LAdlarapo/, s Try �/(9das 6ii-R�' / , S� 1/603(3
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
1-X7 30
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE - EXTENSION
I a Ser.( Sale 7ia„ I,�, �is� 310=
•
I
t
,jiff r�ra_
•
N 4r,#.•0%...,... . st .... VII h.
: :4/ (1) H
Send Invoice To: , CO—- M- (`J;� �� •
� l/llf
PLEASE INVOICE IN DUPLICATE
SZia• �'�
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I ' AMOUNT/
/o2O g3ST3 07) 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 HERESY ERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APP PRIATION SUFFICIENT TO PM FOR THE ABOVE ORDER.
•SHIP REPAID. p
•GO.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL i
SHIPPING LABELS. •1 /4/2/5-61,--C., / /� J{L�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE O✓ /� Y*�l� ( '•
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2,•)0 11 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY