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y O 1\ air CERTIFICATE NO. 003120155 002 0
Ci S. wa PURCRCHASHAS
E ORD R NUMBER
FEDERAL EXCISE TAX EXEMPT r
35- 60000972 CP
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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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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1 ...615,02 00 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT r PROJECT ACCOUNT AMOUNT
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AIP /OUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
S 1 NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
I SA 5 4 VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS .1\- 4`
t 4_, I HEREBY CERTIFY THAT THERE ISANUNOBLIGATED BALANCE IN d
R. .THI PRIATION SUFFICIENT TO PAY FOR THE •RDER,
SHIP REPAID
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.D. SH CANNOT BE ACCEPTED. 1 ORDERED BY _at .4, �'1
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING U
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THIS ORDER R ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 II, N O�Vd ✓A, AA---N-1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
2 CLERK- TREASURER 11
DOCUMENT CONTROL NO. OFFICE COPY 171)