26368 General Dynamics ItronixCi 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 0RUE,I UMBER
THIS NUMBER MUST APPEAR ON INVOICES, AT
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE,
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
F DESCRIPTION
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VENDOR P () 80 e/9Si
SHIP
TO
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CONFIRMATION
BLANKET
CONTRACT
- „ • PAYMENTTERMS _
FREIGHT
•
QUANTITY (UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Send Invoice To:
DEPARTMENT
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PLEASE INVOICE IN DUPLICATE
497 • 6
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ACCOUNT
PROJECT
PROJECT ACCOUNT
AMOUNT
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SHIPPING INSTRUCTIONS
• SHIP REPAID.
• C.O.O. SHIPMENTS CANNOT' BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUE() IN COMPLIANCE WITH CHAPTEFI ED, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO,
ORDERED BY
PAYMENT
• AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER 15 MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
HEREBY CERTIFY THAT THERE IS AN UNOELIGATED BALANCE IN
THI$^,AG` • OPRIATION SUEFICIENT TO PAY FOR THE ABOVE ORDER.
DOCUMENT CONTROL NO. 26368 CLERK - TREASURER OFFICE COPY