31782 Burrell Appraisal Servicew of Carmel
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
3/712
THIS NUMBER MUST APPEAR ON INVOICES, AP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
VENDOR Burrell Apprai5AI $etvlrejib/
1$O 4/hi Ie\ Drive, 5u i 1 e P
• , I •
SHIP (R<
TO
30 W Ain 54, Su;/r 220
%4 flllef,7N L6032
-. 11n1 f0A P1111h 1. (' -I 11L I11 1 +i4
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY I UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To
CRC
30 V. slain 5i., Sus t f 220
lArmPl, 1 /1/ 4603 ?_
r eh) fAni r((Is
PLEASE INVOICE IN DUPLICATE
42/U "'
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
180)
Lt 350900
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.
ORDERED BY
TITLE
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.
_re-
67. (' /lye La/m:1
U
DOCUMENT CONTROL NO. 317 82 CLERK - TREASURER
A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE
I