34555 AUTOMATIC SUPPLY V ! INDIANA RETAIL TAX EXEMPTciiicy
a �` l,`��' r CERTIFICATE NO.003120155 002 0
PURL SE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT j '5 ,S-S
35-60000972
0 !E CIVIC SQUARE
C'.riM_L, INDIANA 46032-2584 THIS I`N.'ME._R MUST APPEAR ON INVOICES,NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APri-le'Y ED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 St IIPPINGLABELSANDANYCORRESPONDENCE.
'URCF SE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
/- d-ig I - 69.- /e 065soda 1 dSftvdcc `-A-,i
16MAk'/`L /
1/l' oSi¢9-90 A-060 orL
SHIP
/ENDOR TO
/ /-f-6/C(/ , .7-/t) 1/4034'
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
. gi 3°
QUANTITY 7 UNIT OF MEASURE DESCRIPTION` UNIT PRICE EXTENSION
/ / d ��
66x/ '19//9-F� k '/? f J 36VaUv
end Invoice To: /�
3 ,le& 66/P C��i4'
1..4/02-6 afcs/7'"2r d2kal
600E2 ,J /403 1,50`707,
(z
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
/07° VS-ro 9616 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 UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS THISAPPROPRIATION SUFFICIENT TO AY FOR THE, .BOVE ORDER.
SHIP PREPAID. .-----C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY w+ ' /
PURCHASE ORDER NUMBER MUST APPEAR ON ALL '
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ��� l/5. -{'.-/'r'r Y ed, 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
OCUMENT CONTROL NO. 35 '