26353 Hoosier Heritage Port Authority City of' /,fTh 111111 INDIANA RETAIL TAX EXEMPT PAGE
Carmel CERTIFICATE NO. 0031201550020
�v y y Ja PURCHASE ORD NUMBER
FEDERAL EXCISE TAX EXEMPT nC 3 S 2
35- 60000972 !O
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
f9 8-9 [,huh 5 ;r Q I Aaf r�
VENDOR 33 4) •9r 51 SHIP
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE I DESCRIPTION t. d UNIT PRICE I EXTENSION
i i Anil �rrrr '‘dv an
�rm 1 kiln?'
0 9,0 to5
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Send Invoice To: l l�. Q u v(
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PLEASE INVOICE IN DUPLICATE
.DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
9' 2 57s Q 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 ATTACHE.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BA NCE IN
SHIP REPAID. THIS APP R• TION SUFFCIENT TO PAY FOR THE ABe O• e•p_
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY i a �'a
r i
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE t. I j i
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 9
2 6 3 5 3 CLERK TREASURER
DOCUMENT CONTROL NO. OFFICE COPY