31748 Carmel City Center City o f Carmel INDIANA RETAIL TAX 015500 PAGE
S. 1111 CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3\ '7 L{ _
I
35-60000972
''
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AP
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
3/31 ) 1-I
Carmel G+i Cevf r, L1-Q CI+13 of Ca✓rne•1
VENDOR Orli 7,fCtOY 59,UR✓Pi SHIP Cornmu✓I/hi Rci&Tlov,s -beryl-.`770 3rd Ave 5th TO One- C V c Srbua c
Cos-nit l, S1.} gIn032— Carmel TN 4Lau3Z
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT .
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE 1 EXTENSION
Y2e1rY) 9uvservlelnt to felted Gij Cevner 4 PbICCLboll r7 00
pcwFTxmaxi it a-- Ok-b r-Ps+ a
• (OO/ - -407'I
: � ,
Nilllok
U M _�° f 0
Send Invoice To: _ // r
1203t4a5g003 fJf j OoU . 00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT j
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 THAT THER IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATION BUF �WO B: sR THE ABOVE ORDER
•C .SHIPMENTS CANNOT BE ACCEPTED.
COD. i
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
ORDERED BY '
SHIPPING LABELS.
/ A
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE /1CC/___ L- 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 31748 OFFICE COPY