31831 Christopher Burke Engineer A •\- :Lr• 1' INDIANA RETAIL TAX EXEMPT 'PAGE
?T-L \�%* �'�� Carmel��I' It I' (�� - "-'CERTIFICATE NO.003120155 002 0
`>•' y ��► a lnl PURCHASE ORDER NUMBER
. FEDERAL EXCISE TAX EXEMPT 3 ..I
35-60000972 ii7�(y
•
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
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Ch.1":Skt kj,key i';_t✓\CC Enc. g\eev;,ns
VENDOR \\S VJ • YNICLSh`I\C 1V/1 SHIP -ek - �C b 1`ne Ells V1
a . Sc SF I ,b� Kati TO S
d-c3lS,1 -ctv 4 Lo 2.04
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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ON. ac ke s ls� (3
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ti. V v fie, 4,f d p • 0 ues_ .•
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Send Invoice To: � , ���
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to S ���r1 ll<fi. ` 10,0coo
•
21\ -40\
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 HEREBY CERTIFY IATHERE
TI EIS AN UNOBLIGATED BALANCE IN
THISAPPRIO I NT TO PAY FOR THE ABA VE ORDER.
+• SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ° C
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE ,- / '��""�•�+�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ' r
i -.�..
--CLERK-TREASURER '14r :a
DOCUMENT CONTROL NO 31831 •OFFICE COPY