26557 Crossroad Engineers CityINDIANA RETAIL TAX EXEMPT PAGE
® Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT (0CC+
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR
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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 ro `t 100 0 .on
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PLEASE INVOICE IN DUPLICATE
• DEPARTMENT ACCOUNT PROJECT . 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 PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTI THAT THERE IS AN UNOBLIGATED BALANCE IN
.•SHIP REPAID. /
THIS APPROP KM IIJESICIENT TO PAY FOR)HE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. "+I /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY _ �� -'^'� �+ ��
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ,•�rl1.�! ��
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. r
Q���� CLERK-TREASURER
DOCUMENT CONTROL NO. �J OFFICE COPY