31901 Crossroad EngineersI City of f ' v armel INDIANA RETAIL TAX EXEMPT 155 00 PAGE
1111 1111 Ili./ CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT DI
35-60000972 "I
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL^,'INDIANA 46032-2564 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
II
CVCSSYOQLd.. ■VSQSLV5 SHIP 1 n
VENDOR TO `1 . OT stY■40 ,,r1 As
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Afro or
ar .
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Call �t i 0.A A.
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Send Invoice To: �r N 66 -0 ��
S 11111 A I12sg•�
21\ - 4O\
- PLEASE INVOICE IN DUPLICATE
•
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
•
PAYMENT
•
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE P5OPER SWORN AFFIDAVIT ATTACHED.
■
E SHIPPING INSTRUCTIONS • I HEREBY CERTIFY T ATTHERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA11p_RUF fCIEP NT TO PAY FOR FIE ABOVE ORDER.
•SHIP REPAID
. \ ,-',�/(—}L•. _,_ /`� `q
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY (/'//��//y �- �(�
•PURCHASE SHIPPING L BELS NUMBER MUST APPEAR ON ALL !// 1
SHIPPING LABELS �
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
3 0 I 1 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY 1
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