26282 Ashpaugh Electric•
of Carmel
''ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
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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. AIP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
(PURCHASE ORDER DATE
DATE REOUIREO
REQUISITION NO.
VENDOR NO.
DESCRIPTION
[p1 it k.
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VENDOR
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• 1 Y9t;„ £.d/ duu.. 5
4004
U +.
SHIP
TO
d_axma. 5h' t• & pr.
\3 O6 ca. 13fatX51-
4O��m�r.�j�L(Oo Il�
CONFIRMATION'
BLANKET
CONTRACT
PAYMENT TERMS
FREIGHT
s
QUANTITY. !UNIT OF MEASURE
Send Invoice To:
• i,'j DESCRIPTION
C Ck. A 019
1 UNIT PRICE I /
�7G 5,�
7
Curt -4 56
.a
PLEASE INVOICE IN DUPLICATE
EXTENSION
p�ga6.+63
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
SHIPPING INSTRUCTIONS'.'
• SHIP REPAID
• C.0 D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
. • THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1V45
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 26282
PAYMENT
•
• AP 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 AFFIDAVITATTACHED.
HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENTT PAY FOR THE ABOVE ORDER.
ORDERED BY
1TITLE
CLERK- TREASURER
OFFICE COPY
ClAtikk
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