26460 Republic Services INDIANA RETAIL TAX EXEMPT
CE PAGE
City L
of Carmel CERTIFICATE NO. 003120155 002 0 I `Ol
a- ®Ia PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2_ �l I O
35- 60000972 `1D
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, ATP
CARMEL, INDIANA46032 -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
2 4 4 2)2 Z ��sL. _Ssvice_
l C. �VV 1C25
VENDOR
1 SHIP CCS-r^r` C C
S 3z to -.6 c- 9- kYc-\1. TO Q C,viC.
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE f DESCRIPTION 11 UNIT PRICE EXTENSION
SL, C o>>Q�..�,� i C
0 oc CAQ,
11111114,
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NOW
Send Invoice To.
Cccrvo.\ C I� c�\�
G V C
G•C C\ 1 DTI 43C PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
12.0_5 S I '1 PAYMENT
NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P0.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE TOPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY VAT AT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT10 'SUFFICIENT TO PAY FOR TH1ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
26460 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY