27359 The Kitchen Wright City ty of f Ili/ vane l INDIANA RETAIL TAX PAGE
CERTIFICATE NO. 003120155 0155 00 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, Am
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
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VENDOR 9 /a q 5 i......yez t e 6,4, /66 TOIP
COAfind XJ A/643.2
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
OUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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PLEASE INVOICE IN DUPLICATE �.3 /67
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT 1 AMOUNT
/20f SO PAYMENT
AP 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 HEREBV ERTIFY THAT THERE IS AN UNODLIGATED BALANCE IN
THIS APP RI SUFFICIENT TPry AV FOR THE ABOVE 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.
2 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY