25842 Crossroad Engineering City Carmel A RETAIL N TAX EXEMPT 15500 PAGE
J i y I'� CERTIFICATE TAI TAX 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT St 35- 60000972 J O
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
C VO5V 0 Cx.8, f..r■ Aaj.YS
VENDOR SHIP Q "C,�
TO ll.� St 7l4 9j✓� 11
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
E 1
r 2_
,al(
0 (i)
`me j y
Ca 1 C a S
b
a
s2*- W
Ns, M NrE
Send Invoice To
2--8---- PLEASE INVOICE IN DUPLICA 211
DEPARTMENT, ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P0.
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 APPROPRIATION' FFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �J_./�
SHIPPING ORDER ISSUED y;
THIS ORDER R ISS ISSUED INCOMPLIANCE WITH CHAPTER 99, ACTS 1995 TITLE �j ��''I
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 2584 2 OFFICE COPY