31732 ICLEF INDIANA RETAIL TAX EXEMPT PAGE
1 City o C°, r e l CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3 I 'T 2 '"1
35-60000972 ( `J O�
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
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VENDOR n (riri O 1"'L F ConFe(QnCC 6‘)n-fxr SHIP
c)3V E• iDS+• )SUif-Q 30O TO
t r cnapoll , it.! i.) o'f
CONFIRMATION BLANKET . CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
q-056+C-C4'fi an Gr Strny el 6i-f- dttor ne\I
$0925. OD
100i16,5 . - 0-ey -i-o a if_e n d
L E r 5'7 PII .Ufa rAte.`" 1 `�/0,_
P
Apri 4, -,, ".\._
,4,,\, :0 /\+ 3"
i t
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Send Invoice To: `- r" _
•
One 5q 06(6 L`IvI e
CGrn 1 , ) s L03D
PLEASE INVOICE IN DUPLICATE
Q DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
) 10) J--1'15tCuC�Qf CLI 1 c"-eLS "l 00 L) PAYMENT 07 76, 00
• 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 THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID - WM
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. / il ....1_ /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE .t ,Q,I 1—I si i n rl y.h.
\
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER 1
DOCUMENT CONTROL NO. 317 32 OFFICE COPY I
I