27842 TMT INDIANA RETAIL TAX EXEMPT PAGE
City CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT r) i
35- 60000972 r
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, NP
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 C, ciii7tH€c
w'is�LIe 1�1 ,0 T Oius Chili G
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
i i /0/901/4-) r c) ‘116)
:y
.45fL
Send Invoice To. b JA X71 1t..i J
GYU d, *fy c- w d4tn)Q.L. 1J Y3- sU4 _6--o
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CrT< "£L. ;rJ
Nc/c PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
NP 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 CERTIFY THAT-THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROP IATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIPREPAID
C. 0 SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY r
SHIPPING LABELS /Y J{
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THEERETO.
DOCUMENT CONTROL NO. 27842 CLERK TREASURER
A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE