31916 Red Valveof 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
319 1•l0
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE D
DATE REQUIRED R
REQUISITION NO. V
VENDOR NO. D
DESCRIPTION
Id- /liII9
VENDOR
Qedd Valve Conrpo-nj,lrlc,
l000 Nor +h Pell Avenue
1'. o. Box 549
Come-se , PA 15I O(. -054-9
SHIP
TO
8 H,5J- inee
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
Eng inee-1r3 .
I-10'I TF -1 -Ttcle f lex.
Chec ■c Vcdve
for E mien on Road
PLEASE INVOICE IN DUPLICATE
N"Tt: �IO,SZ"�.SZ
q12- I-11- 1102;00
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. 31916
ORDERED BY
TITLE
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 PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTI HAT THERE IS AN UNOBLIGAT D BALANCE IN
THIS APPROPRI O ICIENT TO PAY FOR E ABOVE ORDER.
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