26285 PurdueCity of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO, 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE•
PURCHASE ORDER NUMBER
THIS NUMBER MUST APPEAR ON INVOICES, AR
VOUCHER, DELIVERY MEMO, PACKING SLIP$,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
VENDOR
CONFIRMATION
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BLANKET
PAYMENT TERMS
SHIP
' TO
FREIGHT
QUANTITY
UNIT OF .MEASURE1
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
AU. v ire o1
PLEASE INVOICE IN DUPLICATE
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DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS
• SHIP REPAID_
• C.O.D. SHIPMENTS CANNOT DE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND, ACTS AMENDATORYTHEREOFAND SUPPLEMENT THERETO.
. DOCUMENT CONTROL
26285
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
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.
• I HEREBY CERTIFY THAT TI IERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION-SLIFFICIENT TO PAY FOR THE ABOVE ORDER.
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