33400 American Structurepointof 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 N0. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35-60000972
PAGE
PURCHASE ORDER NUMBER
3-3 0
THIS NUMBER MUST APPEAR ON INVOICES, NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
3URCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
illIR115
VENDOR
Amery can 51-rLA LArepoint
-1 2 (D O Shade 1 and 5'1 Ct_ti o r-%
I r -t1 n_nc'po % ItV
L -I (D2510
SHIP
TO
Dop0-e-tern ent of-
1✓rlq In ter,
CONFIRMATION
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE I
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
EryIn Per. n
PLEASEINVOICEIN DUPLICATE
ASASt 11
Con -hr a ci Ocs-tt 3)201.13
Pro jec+
1'
On- Call E.nee" r'y
�Ssst cinCe
00
NyT E : *35, coo -7-
21‘—
21e— 113"101 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. 33400
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 E PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY C FY TH:LTHERE IS AN UNOBLIGATED BALANCE IN
THIS APP b. SUFFICIENT TO PAY F• R THE ABOVE ORDER.