32302 City of Carmel �° Carmel INDIANA RETAIL TAX EXEMPT PAGE 1
C � ®,Jlr CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3 g9 P_
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 I
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
6/ekh 01-C' - 4itil rIA. C/
VENDOR x.1-. NAM SHIP ( '
TO v
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: � Li� f
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lit 1 121-1'1 I)-o G 0 PLEASE INVOICE IN DUPLICATE A (61 o b i) 4 I,--? .11S-
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• A/P 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.
SHIPPING INSTRUCTIONS • I HER Y CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS O RIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
(jtiLat• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 2 3 0 2 VENDOR COPY