24585 Atlas Restaurant Supply City o f Carmen INDIANA RETAIL TAX EXEMPT PAGE N. �� \
Carmel CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 2
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
412812014 .. yN
Atlas Restaurant Supply Cannel Fire Department
VENDOR TOHIP 2 Cannel Civic Square
PO Box 4075 Cannel, IN 46032
South Bend, IN 46634 (317)571-2622
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE.\ DESCRIPTION UNIT PRICE EXTENSION
■. )
Account 102.670.99
1 Each Per attached Quote C $693.44 $693.44
� � �\,_�—�i a–v ��x a"• Sub Total: $693.44
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rdr,Send Invoice To: '—.r. --- . ���0fr •
Cannel Fire Department JlrJ1/ jj
2 Cannel Civic Square
Cannel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 1 AMOUNT
1
Cannel Fire Department PAYMENT Q�p3
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O"
e 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 SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• SHIP REPAID. �\ \
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY V�����-/
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ((( \
SHIPPING LABELS. e R�_ ��9v
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE \ �
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. U
24585 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY
1