31735 Skill Pathchi
of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA46032 -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
31735
THIS NUMBER MUST APPEAR ON INVOICES. NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
VENDOR
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,cons ddf1 and nEep
SHIP
TO
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
1
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
R.Q5i5-Ka -fiem G)r Amanda_ 2fide tf.
D 0 tfend A m,niSkG-H, f155rS± n1.5
(lan &enne , �� _ i n if col' ! N
PLEASE INVOICE IN DUPLICATE
DEPARTMENT
Lao
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
. 113o 4135700 '-►
EX-be rncd 1 n5t ret5
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
�' I9c, 00
• 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 ABPROPRFATTON-SUEFICIENT TO PAY FOR THE ABOVE ORDER.
q C CLERK- TREASURER
DOCUMENT CONTROL NO. 317 3 5 A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE