26475 Greenstreet Ltd. CityINDIANA RETAIL TAX EXEMPT PAGE
®� �� CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
'c; FEDERAL EXCISE TAX EXEMPT C 6# 15'
35-60000972 �!
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/F
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
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: ''`i- C) Rq m•
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0,V/ ' "I'I'J 4°O32-PLEASE INVOICE IN DUPLICATE
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DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
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
VOUCHA HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I SHIPPING INSTRUCTIONS • I HER BY ERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
TH S APPROPRIATION SUF ICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. /[y�F :f;-°,F
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / if / )1 k,
1 •PURCHASE ORDER NUMBER MUST APPEAR ON ALL /�i
SHIPPING LABELS. / i ��r,/1'F/t'//1 t f i.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /' II J 1 I� W^�.•t�•t�LJ:. C—.-.:
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 0
CLERK-TREASURER I/
DOCUMENT CONTROL NO. 26475 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE