26462 IDville 0 INDIANA RETAIL TAX EXEMPT PAGE , n
Clity ®f Carmel CERTIFICATE NO 003120155 00210 ...DI
PURCHASE ORDER NUMBER
/ • FEDERAL EXCISE TAX EXEMPT
35-60000972 �����
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS - FREIGHT
QUANTITY UNIT OF MEASURE 1 DESCRIPTIONS UNIT PRICE EXTENSION
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Send Invoice To: ''/ `" � '. ;
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1E0_5 _ 1 PAYMENT
• A/P 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 AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
ORDERED BY /34-"--4"-`—'---6---a.• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
•
DOCUMENT CONTROL NO. 26462 CLERK-TREASURER
OFFICE COPY