26554 A & F Engineering A INDIANA RETAIL TAX EXEMPT
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i ®f Carmel li rme I'n CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2(0Sc-4
35-60000972
i
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
3�s �.shy. SHIP -0 e--)k. °c E� i, v;
VENDOR CV��,A j I S .to 20t TO \ J
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
•
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
0.e
'
•X2 7
'�%wo 1� -a, 09 -off�•
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Send Invoice To: -0 �
1 +,S-00 0 0
J
f 211- 90
PLEASE INVOICE IN DUPLICATE
. DEPARTMENT ACCOUNT PROJECT r PROJECT ACCOUNT AMOUNT
PAYMENT
• NP 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 RIPER WORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY H T H. E IS AN UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS • THIS APPROPRIA U CI T TO PAY FOR THE ABOVE ORDER
• .
SHIP REPAID. .
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY /`� •
•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.
CLERK-TREASURER .
DOCUMENT CONTROL NO. 5 OFFICE COPY