31750 St. Paul and the Broken Bones LLC City ®f Carmel C INDIANA RETAIL TAX EXEMPT 155 00 PAGE
Illl CERTIFICATE NO:003120155 002 0
PURCHASE ORDER NUMBER
317st
FEDERAL EXCISE TAX EXEMPT
4 35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCH , DELIVERY . SE ,
SHIPPING ER LABELS DEIVE AND ANY MEMO CORRESPONDENCPACKING IP .
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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1 Si Paul and -Hy BrokIn gaus,LLc l, � o-i Corm,cl
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VENDOR I.0. Box ILoo%O SHIP COmMOrjt1'i IttledItrel.$ �pi".
NO5hvill -1-1. 31211a TO Onc CAVIL, Sguan
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CONFIRMATION ' BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION _
Ou+dour ev,t-crtainrn -n r -F,,,. 41\2_ fl-yi-s 4 sin District Ili SOD. c'D
AY4- D.( IFIYI.t Sal-wacky , July ∎012111-1
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Send Invoice To t 0 k �O_se$5q - CoVnmvnl+ RtIoJ1 nl G-J4- Fund
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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 THAT THERE IS AANNN UUNOBLIGATED BALANCE IN
THIS• SHIP REPAID.
APPROPRIATIOFFICI AV FOR THE ABOVE ORDER.
• C.0.0.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY cli
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. A/n/�'�A
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE !_'°' - `/V//v/q((41 /- vi-f/rAM .IIXCtx- D%
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. U U
CLERK-TREASURER
1 DOCUMENT CONTROL NO. 317 50 OFFICE COPY