32374 Keller Macaluso LLCCity of Carmel
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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
3a3 7 �l
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
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K ,eIIe`c (fl c&1030, «c
VENDOR
SHIP
TO
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY I UNIT OF MEASURE
DESCRIPTION
Send Invoice To: •
Lejal Ser✓icp5 rendg( id -FD
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Jo) Li £nc ombat t c e
PLEASE INVOICE IN DUPLICATE
UNIT PRICE.
EXTENSION
/5,3719, &)
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
LcIAD 11s0 Nay000v
LOSE ! Cze,5
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.OD. 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. 32374 CLERK - TREASURER
OFFICE COPY
PAYMENT
415; 370. Dd
• 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
THIS APEBBPRI - - ICIENT TO PAY FOR THE ABOVE 0