31624 I.M.L.A 0 INDIANA RETAIL TAX EXEMPT PAGE
\�/ ® °�� (�l CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
•" w FEDERAL EXCISE TAX EXEMPT 3 / j 3/ ' '
•
• 35-60000972 CO `-J •••.
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
51/42olq
•
VENDOR SHIP
TO
•
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
•
rkti3fra+1on Tvr Ci+ y 0-r CG r l qg, JO
Assis+an+ Ci+y A-torruy, Ask -Py UI br;ch F
-iv otf-.onc! App - ate 70 o . municc-hons
-T50 (-01 •C�q ,,
$4?
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Send Invoice To: Y O J\ f
.• lull
PLEASE INVOICE IN DUPLICATE
�Lp DEPARTMENT f ^ACCOUINT . I PROJECT PROJECT ACCOUNT ,�AIIMOOUNT •`-�)
1) "O N357o6y _(J)>ffdc5ona/7.2X5 PAYMENT ER CANNOT BE APPROVED FOR PAYMENT UNLESS THE�' iV
• NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. ',1,-.
SHIPPING INSTRUCTIONS • • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN •
•SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
\.
SHIPPING LABELS. 1
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE • L-- "+•ems-_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, k� J
CLERK-TREASURER . -- --
DOCUMENT CONTROL NO. 31624 OFFICE COPY ./