31543 American Structurepoint CitY INDIANA RETAIL TAX EXEMPT PAGE
®�tCarmel.anal. CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
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FEDERAL EXCISE TAX EXEMPT �j J5 to
• 35-60000972 J
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
■
I •
VENDOR Mel I (th S4-rgc tr 1°NOII I I . SHIP C I�
"72 60 S d rIan d 3-fit-bon. TO '30 W A it)4 it
.InJidic(polijc j4i 46256 • (&rin eLIN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
•
QUANTITY • UNIT OF MEASURE DESCRIPTION .UNIT PRICE EXTENSION
Q 1-ipn i wk.' ie c 4-urAl/en9; nee rih9 419 S00."
5 rvi (ec for -1-he NHSA Froje f •
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•
, oil • II:=Z•"'" -- -- .
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Send Invoice To: ' ,N�i- ��'{5f °° -
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30 W Fittv n 5�• .
(mrme\ IN '-6032
PLEASE INVOICE IN DUPLICATE .
DEPARTMENT . ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT •
1 902 L "I 601 S4 • PAYMENT
I • 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 CERTIFY/JHAT THERE IS AN UNOBLIGATED BALANCE IN •
THIS APPROPRIAJON SUFFICIENT TO PAY OR THE ABOVE ORDER.
•SHIP REPAID. , •
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. iiir i
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
Y SHIPPING LABELS. A;•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE At---"-------1. .
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 31543 OFFICE COPY