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31734 IMLA INDIANA RETAIL TAX EXEMPT f City -of 0�i rmel CERTIFICATE NO.003120155 002 0 PURCHASE PAGE ORDER NUMBER I 0 AIS(.0 o 1 l I--a 0 FEDERAL EXCISE TAX EXEMPT 1-1� 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,'VP 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 VENDOR 79)o woo c t 0r1`4` T IV.e, 5-Le rI"4 4 1) SHIP TO -e 1--,h16 cr ct. , 11 IS do e i' CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION .e 1,5 0n '( ° \1 $350` °° I A. 1 , 115 \*A) i X . J 1 b i t A - a Pin 61 ..��.. rn 1 17607177-... 4 oa I.„,...6,, li :0 iv t P it_ t . L Send Invoice To: r �" PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT f PROJECT ACCOUNT AMOUNT /) ) ' G- '•J 1-1 6-7OO' _ PAYMENT 5o, oo•�� 1 A P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. "�->r1JI 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 AN.UNQBLIGATED BALANCE IN THIS.APPROPRIATioN-SUPFlCIENTTO PA OR THE ABOVE ORDER. •SHIP REPAID. try '�" •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /1„--------------) • PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 4 ('G'I,e 1 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE