31913 Dellof Carniel
• 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
31g13
THIS NUMBER MUST APPEAR ON INVOICES, /VP
VOUCHER, DELIVERY MEMO. PACKING SLIPS.
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
12jr3 Ily
De11
VENDOR
SHIP
TO
Terry Crockett
3 c ■•, c Scv.Aore
Carmel, 11'4
44.0032-
• CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To
er9;r,eer;rNs
PLEASE INVOICE IN DUPLICATE
VL.A O(t1te Pro Plus
2 013
5-c e Quote -tt 84191ot1.5
LITE
cM 3210.'I ei
22.00- lo 32..02_
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.
ORDERED BY
TITLE
CLERK - TREASURER
DOCUMENT CONTROL NO. 31913 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 CERTIFY T AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA •N SUFFICIENT TO PAY Fr R THE ABOVE ORDER.