31753 Monika Herzig City o f Carmel INDIANA RETAIL TAX EXEMPT 155 00 PAGE
1111 1111 CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT J I'-7 5 3
35-60000972 -
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.
1 FORM APPROVED BY.STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 _
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO DESCRIPTION
1
Moniker 1-kcji � Clime of COrwul
VENDOR 3375 E. Old Meters rz c1 . SHIP Co unli"yl RIIGTi CrIS aQp+
TO OrI e G;. ws
a Dom,v-iy-D✓t / 7N y7k-IUS Cormcl 171 JUru32
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION'
�Q 77 0✓I ,-I �c rviov1 on per-{vr rvIeth(.2- - 7/249ii Li 1.9 OD. '�O
�" TES/_
aLissfat
•
14*
Send Invoice To: M. -.�
I2o3/ LI35Coo3 Sall"
3 60o.°Q
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 AN UNOBLIGATED BALANCE IN
•SHIP RSHAID. THIS APPROPR1ANON SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED
. ORDERED BY f+Y///l eITl1_` __` .
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. 'Ala-T-6-m- J�1 ((n�/����Q�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE -�.. rf17NiYl1.LLJLl A N- -g1.
' ANDACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO d ' d
CLERK-TREASURER
•
DOCUMENTCONTROL,NO 3, 753 OFFICE COPY•