31917 C H A ConsultingA -
--- •ONE.CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OFjACCOUNTS FOR CITY OF CARMEL - 1997 ,
INDIANA RETAIL TAX EXEMPT
"-CERTIFICATE' N0: 003120155.002,0_
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
31 Q 1 9-
.THIS.NUMBER.MUST.APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
I• , .' I I n I
'PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
12 /II '1y-
VENDOR
CHA
U n'lo(1
Si aii On
300 Sold --tH Pert °Ilan Street
I n d an- 0-p o l, N., I N
1-11.02.2.5
SHIP
TO
E ng,rl eetn I-
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
En91n- e'2nri
LPA Cons» I o.-,t
5tooi e best 13831 (c(0
MctiIn Street Pat1n - KeysttDnC
A-0 Gra.' Rootd
COns try Cron Inspect; On
Con*C C.t
PLEASE INVOICE IN DUPLICATE
'fc To be Rei nbv-r- d k,1
S+ ate -%
NTE : 11 I I I, q 0000
$ gq,s2o - 9oo- 4ycozeGR-
940.58 2200-4350900
3,40$.39
3,oC98•QI
1 1's,Sto1.48
2700 - R L14 (0206 O
P• o. 31280
22_60- 444,2000
2200 - 944(02°00
I,S00. 104 2200- 43140100
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.
ORDERED BY
• TITLE
DOCUMENT CONTROL NO. 31917 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 P PER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY T AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT /FFIGIENT TO PAY FO r'HE ABOVE ORDER.