26302 B.W. RogersCity 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. 0031201 55 002 0
FEDERAL EXCISE TAX EXEMPT
35. 60000972
PAGE
PURCHASE ORDER NUMBER
TRW NUMBER MUST APPEAR ON INVOICES, A•P
VOUCH�I,{VEPY MEMO, PACKING SLIPS.
SHIPPI EES AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO
DESCRIPTION
Noblesville,
IN
46060 -4383
(317) 733 -2001
91262012
VENDOR
B. W. Rogers Co.
SHIP
TO
Street Department
3400 W. 131st Street
CONFIRMATION
A4KER
Stg3yRA Tdpe-
k Way PAYMENT TERMS
Cannel, IN 4b1.114 FREIGHT
Noblesville,
IN
46060 -4383
(317) 733 -2001
QUANTITY 1 UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EY'IENSIGN
Account 0042 -370.00
1 Each CIMR- P7U40111B P7 Drive, 480V, 27
1 Each C- 800028 Capacitor LXN130 400
1150uF 105C
Send Invoice To:
Street Department
3400 W. 131st Street
DR% &ii FS ; IN 460i4
PLEASE INVOICE IN DUPLICATE
11,356.21 11.358.21
$47.07 147.07
Sub Total: 11A03.28
ACCOUNT
PROJECT 1 PROJECT ACCOUNT
AMOUNT
Carmel SYryA DITR IRS'fi4UCTI0NS
• SHIP REPAID.
• C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO_
DOCUMENT CONTROL NO. 26302
ORDERED BY
TITLE
CLERK - TREASURER
OFFICE COPY
PAYMENT
• Air VOUCHER CANNOT DE 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" +
• I HEREBY CERTIFY THAT THERE IS AN UNOPI.IGATED BALAN E•IN03• -"
THIS APPROPRIATION UFFICIEN TO PAY FOP THE ABOVE ORDER.
60