32011 Hoosier Portable Restrooms City O of f Carmel INDIANA RETAIL TAX EXEMPT 155 00 PAGE
I'�./ CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 32o1 1
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
(0 / 171)il
IIUDSITY Rvtabl{, 12t3+r n,3 C{}la 0-c Car1T&
VENDOR 2201 E. Q qi" 5i-. SHIP COrnmUnlha Picatnro Derr(.
TVI�I(in(,L �IS� .� TO on( (IvICUSfllsv�. '
pD 'J goo COPANI, 2,UUu&o3Z
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
•
' QUANTITY UNIT OF MEASURE DESCRIPTION •UNIT PRICE EXTENSION
1
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Send Invoice To: - ° _ � �
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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 • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIONS FFICI NT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING ORDER ISSUED I'11� 2 D L
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1905 . TITLE !NI'1 ("nun r�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 32011 OFFICE COPY .