27356 A M K Services Cif ty ®11 q v C INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 7 35
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, MP
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
emir( 3..n.ti- 1/C
L 1 1• III Rd SHIP
VENDOR
�a 9 C' g ua P Kl TO
Ci 6 4 /3v3/
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION N. UNIT PRICE j EXTENSION
0 1/47r) 73oc f l ta ?acl.gTo 7/30,
I 8 M NZ 2.4 9 A l f-75,- P
CZ. teit
in 730 4-4-s
.4
Ci .-4
:off
1 m �1-0"
Send Invoice To:
7 T ah.Po J
L-ait,,.4J i 1.) 14432
PLEASE INVOICE'IN DUPLICATE i (0 99.
DEPARTMENT ACCOUNT 'I PROJECT. PROJECT ACCOUNT I AMOUNT
1 6 3 1 PAYMENT
AIP 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 'OPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY P T_Hf IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA p LT I IENT TO PAY FOR HE ABdVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 40 ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. A
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS 1945 TITLE ,(g/b(J• ,{�~•�1. 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
27356 C TREASURER
DOCUMENT CONTROL NO. OFFICE COPY