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INDIANA RETAIL
EXEMPT
City ®fC.Irmel CERTIFICATE NO0031 015 002 0 PURCHASE ORDER NUMBER \�JJII FEDERAL EXCISE TAX EXEMPT
S-g.S) '
35-60000972
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,MP
VOUCHER, DELIVERY MEMO, PACKING SUPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 SHIPPING LABELS ANDANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED I REQUISITION NO. VENDOR NO. DESCRIPTION
i tpV /1 i 1/L 266,61Qesi S-T6 �i -i l`ee--
Pig& - d/4,..S . -i- e , Sezzocc,s-iki 2C 63 [,-P eb.....412
r7 TOIP /�/�a31 �a/caib �,e y
VENDOR
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e1�ie„ � C1w ? ( - L,0zi
laUo7��.7�
CONFIRMATION BLANK/CONTRACT PAYMENT TERMS FREIGHT
p?_,-1- 26 Ods
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
( S76 : - ��-r 1 .5,9;60 447.3) 354,c
Send Invoice To:
i3,,,,,vme #,‘iee 60/-P cl.L.b
,x/02 0 e rolzs,%,le' P/C(Jy J . 3
e)
J ��.
a $ta . ----,c_ zoos
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
A210 ? /�G� - 5J6 • 5 ? 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 UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS ,tW&�tf�N SUFFICIE T/PAY FOR THE ABOVE ORDER.
•SHIP PREPAID. /�
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / �^J\ flp
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ,qA
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 'r/6 /§-46'10- A
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
., CLERK-TREASURER
)OCUMENT CONTROL NO. 3458 •.