31784 Midwest Constructorsof 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
3/7e/4/
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
fild we5-1- (0ns +rMlforf;!(-�C
2.916 Vlu-1f Font, Soil° D
SHIP
TO
(Rl
30 W Alto h Sf.,$uie 220
T h(li4h Obali5 , J/Y '4622.5 'n nil eI, _L IT '16U.72
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
_ FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
Send Invoice To
(roc +
30 W. /lain 5 *., 5u■ e 22
(Arnie)) Z.N 146032
(oij 4rwriio,a/ work r, r 1`!'f (fl 7 '4'64 7(-
DEPARTMENT
PLEASE INVOICE IN DUPLICATE
UNIT PRICE
236 S10. 00
EXTENSION
ACCOUNT
PROJECT
PROJECT ACCOUNT ,
AMOUNT
g6U807
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.
DOCUMENT CONTROL. NO.31.7 $`4 q
ORDERED BY
TITLE
CLERK - TREASURER
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.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE A
•
t-L l t.
A.P.V. COPY - SIGN AND RETURN TO CLERK'S OFFICE