33131 Brad StedmanCi 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
33/3/
THIS NUMBER MUST APPEAR ON INVOICES, AR
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
Brad 5}edmen, fon4niter-
VENDOR (FP (6rftel)Tni'IAne Ener9q (enftr,LLE
I'21 64-A 5+recd Eny+
Po Box 656
We0 Ft\r,a, ND 5807.'
SHIP CR(
TO 30 W4_A1h Si ,urfe 22o
((rind, -TA/ 46032
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To
(RC
30 W. Ablh 5±. SN'ife 2.20
(i,rmcl, I N t16032_,
2015 annul sdnil -; es 4or Cer+\{dales of
Pnri\it)k}'ton, 5e -1e5 el Mot
PLEASE INVOICE IN DUPLICATE
S13,662
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
902
04 0303
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 1995
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 33131
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 AND
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.
71.
TITLE
CLERK -TREASURER
VENDOR COPY