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®J �r e CERTIFICATE NO. 003120155 002 0 PURCHASE ORDE NUMB ER
FEDERAL EXCISE TAX EXEMPT
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURC ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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1 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE 4. DESCRIPTION 4 UNIT PRICE 'EXTENSION
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Send Invoice To: 1 11�i wJ
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
QO p l C 0 2 PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CER Y THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APP TION UFFI IE TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE. ORDER NUMBER MUST APPEAR ON ALL ORDERED BY 1
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SHIPPING LABELS
OR Are 4
THIS ORDER R ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITL r
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 1 `,t
CLERK- TREASURER a
DOCUMENT CONTROL NO. 258 5 3 OFFICE COPY