31752 Heather Ramsey Clark LLC C O� o f Carmel INDIANA RETAIL TAX EXEMPT 155 00 PAGE
11nLL CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3 I 152_
35-60000972
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
LA eatn,c( r?Gmsc1.I CILIA L_LCC CIt cyft C4,,, o
VENDOR ji{6 L1). i"r1Qlit `si-, SHIP Cove V)'IUni 12e I&nonJ �.(�r.
TO Dnc CwV1C3C6 ritLtI , ZtJ LI(poiZ
C4✓rw l 10 N(0032—
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
37(2z bn ,_1-1. 4 nlun D/1 Pr r Fpm .,-, a 11 "- - b/Zrs'/IL_I ( DU
ro 4 °
t.'., tip
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* 0 11%
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Send Invoice To .-`" . �O
IzoS/�I3Sga03 j
$C90C).CL'
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
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 FFICIENT TO PAY FOR THE ABOVE ORDER.
• SHIP REPAID. I
•CO.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �,/(.(t ,/It//p✓gtA_
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL /V'
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE A:4. • Jul. Al _a _ 24 L 4.._j. . D l ad,
_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. r .._
317 C J 2 CLERK-TREASURER
DOCUMENT CONTROL NO.
OFFICE COPY