32014 92.3 WTTSCity of 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
33o►1-j
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
IA -15- a°l
VENDOR
q2.3 U)TTS
-DD One G+-j Cenwc.
13 1DUMIh51 -DV, , y7yDLl
SHIP
TO
eitti ele Carrn t l
CovYlrnuvl 1�eUt-tions 1Deo
Dine C v iG cb
Cavmei, �) 41.003a
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
1-10 ►i cloud Rack) %10 "Jo drive. *a ADD c h,J
en(ouYece bt'al sh ■r1 .4h _ Arts his-frith
4- COI CPS.-107
Send Invoice To:
i a�31 �I35Q3dC�
PLEASE INVOICE IN DUPLICATE
43, tow. 00
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.0.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. 32014
ORDERED BY
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE ANDS
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
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CLERK - TREASURER
OFFICE COPY