31840 Citizens Waterof Carmel 1
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY, OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972.
PAGE
PURCHASE ORDER NUMBER
314,40
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
°URCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
+ VENDOR NO.
DESCRIPTION
5112114
VENDOR
C - i 2-e2,s W 0 --ter
\22o V'J0--1-er vvay Blvd.
Irck aria polhs, IN �i(o2O2-
SHIP
TO
Dcpt. of �n9i;F ee�I�J
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
• Send Invoice To:
Agreement palms: 511114
Pr eci' it -Ocj
U- 11ii� Re; ry- ,6uis ern ent
PLEASE INVOICE IN DUPLICATE
. 1.TE=
It 54, to (DS . 00
71i- 44(02865
DEPARTMENT
ACCOUNT
,PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99; ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 31840
ORDERED BY
TITLE
CLERK- TREASURER
OFFICE COPY
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.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.