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31903 Crossroad Engineers City of f C sane 11 - INDIANA RETAIL TAX EXEMPT PAGE Carmel CERTIFICATE NO.003120155 002 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 3\9 o? 35-60000972 ONE CIVIC SQUARE t 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 2 1ly`ly VENDOR CY ASS VOa6 \ Ato CS SHIP >e�T 0-Q 1=mss\ An Yi�/1(� TO J -CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE - EXTENSION .1 17.7-," GC ©A '.-4k. 1112_6i ∎3 0 �, < N S.4 "0 ( 0 1 4- x .1i( : 4 a \Le\ ova \0 Circi,t� `• 1C e,!v„ Cl • �e l mzCDC Cleo Tee_An aY✓,ces Send Invoice To. 'ere °" �J O • IC13iR30 2k1-9 01 PLEASE INVOICE IN DUPLICATE • DEPARTMENT ACCOUNT . PROJECT PROJECT ACCOUNT AMOUNT 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 HEREBY CERTIFY TtIAT THERE IS AN UNOBLIGATED BALANCE IN •SHIP REPAID. THIS APPROPRIATI NSUfjFICIEtSTT THE ABfSVV5 ORDER . •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LRBELU. ' •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. • 'i7,%?: CLERK-TREASURER DOCUMENT CONTROL NO. 31903 OFFICE COPY