31910 A&F EngineeringChi
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
31°00
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
laIIRI
Enaneenn53
VENDOR e1,05 Keystone CrossIl-,5
S La, te 201
1ndlano- POYh , IN 4(0240
SHIP
TO
Erg" -,eeri r '
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS -
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
N
Send Invoice To:
Er, Ey - P-er'-S
am Li -i'r a k Sign&
Records } O' -Ca1(
Services
PLEASE INVOICE IN DUPLICATE
BU
-$1$,44
2200 -1- }350900
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.
DOCUMENT CONTROL NO. 31910
ORDERED BY
TITLE
PAYMENT
• MP 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 T AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA . '+N SUFFICIENT TO PAY FOR THE ABOVE ORDER.
CLERK - TREASURER
OFFICE COPY