26357 The Mirazon Group C1 L 312015520
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City Carmel CERTIFICATE NO
��wvv �a PURCHASE NUMBER
FEDERAL EXCISE TAX EXEMPT al!!JJ L 7
J 7 C
35- 60000972
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
194/ O6-a�IZr tatia fivrP
VENDOR 31.)--- WA)11171 V iar fiv.) SHIP r 670( i
v l I TO 'Ca m I
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454 1 1 /ti )4 j 4)-2-2— t{
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS I FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION., 3 s y UNIT PRICE J_ EXTENSION
4 r: q
C o 7 tr l-( �4 S m firm) I/IAl1/-( p5�.
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4 A 1
5� 0 47
Send Invoice To: r'�- ut
J IIljJ
PLEASE INVOICE IN DUPLICATE
3., DEPARTMENT.? ACCOUNT :PROJECT 4 PROJECT ACCOUNT AMOUNT
1� /S
OZ PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERiJFY THAT THERE ISANUNOBLIGATED BALANCE IN
THIS ROP ATION S FFI ENT TO PAY 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 1 a.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 CLERK- TREASURER
DOCUMENT CONTROL NO. OFFICE COPY