20012 Midwest Golf & Turf Q'?� 00 - of //may` .{�.� INDIANA RETAIL TAX EXEMPT PAGE
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1\ I' ® II 1� .��l 1 I' I, �� CERTIFICATE NO.003120155 002 0
is 11 \L/ m JL PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT eXOD---
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEIE7 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
M
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. „- ,. VENDOR NO. DESCRIPTION
/72i okz.cr ( i 4 4 . 13,2 C s A/le L (ooir airy
VENDOR _ SHIP
TO /,)l,2D / 20'66/2. 141
L/9p 0, -.1----) z{GD33
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
(4 Ana-
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 0 i 1 OR� e 7 5 , a7 92/9 1 CC:
.
I ci) jk At ,
• ° ,�
{ [`�'
Send Invoice To: ��k� a � (
13e06/13 4/2 ()D/
CJ J
/&O,i7 /3 oo.e5/i%26 Pm 7
log 67 j- r4 Zege, PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT r' AMOUNT
r<6�401 04 ®ei PAYMENT ■
■ 'P • 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 THALTHERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP RSHAID. / y `� / /
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / ("C.afr
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL +` ,/
SHIPPING OER ISSUED ) }-.- // '
I •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 6(/� ✓'�-r��`----,
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETrO�.
.0 G CLERK-TREASURER
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DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE