31850 Crossroad Engineers / INDIANA RETAIL TAX EXEMPT PAGE
t"y',,. ‘Cd1 e CERTIFICATE NO 0031 201 55 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT I Qs,S 0
35-60000972
T
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
"`t- . 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
1I21I`I
VENDOR. Cr C7 S r GGUC:I EnJC l,'1 eerC , PC SHIP
De o_• c.),( ErS r erit^30 TO slI So�i h 5hermCv-1 p •',"'a
B-eec.h Grove, IN 4(010 .
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
1
•
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
AS #10
Con-h-ac+ E o1--e 5/I /I3
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Send Invoice To: 22 oO P•A 34.O I 00
y - u5,,.-,5 V.O. 2.(05-4-q-
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PLEASE INVOICE IN DUPLICATE .
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
/ • A/P 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 APPROP•IATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. ," 1
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ,�,� _ -
SHIPPING LABELS. -• � `
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE DI.12-1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 318 50 CLERK-TREASURER
OFFICE COPY