25840 Rust Construction City O O Carmel INDIANA RETAIL TAX EXEMPT PAGE I
Il l n l of CERTIFICATE N0O 003120155 155 00 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
t• 35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 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 l V� t t_cor1, 7 c-g SHIP (T E f 1'ISL...v n
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: 1 j C A d 1 -c011 k o
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Zola Z2 FSg$ 54 9241,25} (Crrn. \4341`0
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PLEASE INVOICE IN D LICATE 1 A•-i 6.
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT "1
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.C.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPR•PRI TION:SUFFICIENT TO P Y FOR THE ABOVE ORDER.
SHIP REPAID.
C. O. D. SHIPMENTS CANNOT BE ACCEPTED V
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 f TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 25840
OFFICE COPY