31847 American StructurepointONE CIVIC SQUARE
. CARMEL,•INDIANA 46032- 2584 , ; "�;}
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 0031 2 015 5.002'0
FEDERAL.EXCISE TAX.EXEMPT
35- 60000972
J
PAGE
PURCHASE ORDER NUMBER
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
10151 IL
-.
' /
VENDOR
Amer; epn SirtA Cita epo',nt , jnc.
'=12(90 ShudeIand -54-0-31 on
Inds ana.po s, IN 4(a25 to— 3G5-4
SHIP
TO
�.nJC i n e1„lrs
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
Ens ne es-I^JA
- ASA tt�
- Projeci- I4 -o(o
NA Q;n Sk-reei 17e co,sfi-u then
s Ir- et to Old
me,-;
S0,pp1 ern enta Agreement.
PLEASE INVOICE IN DUPLICATE
N7E: 8434, 143°°
r Bond
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.O. 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 THEREOPAND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 31847
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 PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY C FY TH THERE IS AN UN •: LIGATED BALANCE IN
THIS APPR q' v(,Fj �WSUFFICIENT TO P: ' FOR THE ABOVE ORDER.