26492 Environmental Services Assoc Inc O I Carmel INDIANA RETAIL TAX EXEMPT PAGE
CltY lJlr CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 61/
35- 60000972
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
VENDOR Oe3y c) -laL. ci SHIP
TO
CcvzAK ¢JC n 1 _217
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
cP C ,Pe if 91O 6a
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Send Invoice To: ��1���(
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PLEASE INVOICE IN DUPLICATE 14 991i•
DEPARTMENT ACCOUNT 1 PROJECT PROJECT ACCOUNT AMOUNT
LU I-10 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 HEREB CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS A"Ti ON SUFFICIENT To. PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY G�
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. J 1/ I, p V.l�
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE --..___---1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 26492 CLERK TREASURER
OFFICE COPY