34557 SITE ONE INDIANA RETAIL TAX EXEMPT ^v- /
Cityof C C.Irrael CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT j(i S'S`17
35-60000972
ONE CIVIC SQUARE
CARMEL,INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS ANDANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
h3gE0 6y- l9/P e4,6
j,,2,/,2_0 8,60x,4-6",m- l'2407
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DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
42-61 g3.'Dcia) 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.
• I HEREBY CERTIFY THAT THERE IS AN UNO:,!GATED BALANCE IN
SHIPPING INSTRUCTIONS THIS AEPRO IATION SUFFICIENT TO PAY'•R THE ABOVE ORDER.
SHIP PREPAID. "- n
C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / i/�/-�\ I
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. �/� / / \
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �t"r'/r 1 5��'u'i ✓`'z-l_ �q
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ! .
CLERK-TREASURER `\
IOCUMENT CONTROL NO. 34557 \\\