26463 American Structurepoint, Inc. St-',:i' v ®•� Ciriiie1 INDIANA RETAIL TAX EXEMPT PAGE ll CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 �+ ,.3
ONE CIVIC SQUARE
CARMEL, INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,NP
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO.
VENDOR NO DESCRIPTION
1 la57 'z'
1. 1rCc rvLCTOS „�Y , T;vC .
.'
72�� S s�-�; C CG, ���
VENDOR -� �aN ,�, ���/ SHIP p,,�t
-- ,] ,G ��,..5' -y-N 2_) Z Sl ,,.. ,),-,,e C , v,C .5t...-
CGS wts' -._1-7..) qb, '-1Z
CONFIRMATION BLANKET CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY I UNIT OF MEASURE
DESCRIPTION
I mac' I UNIT PRICE I EXTENSION
Yt'I ,�..D c .��C k,c``U1e. 1-"NNc\.S.5 -i ,r r��-,,,/
1 / I
4 , U 41Q� °. °° ..:*
1 (
ae � ' ,° � ,
.11$ :fi,_,J /4\
moo ° ° ,:i
lik\ 1. r__,-,1-1_, _ OD
.:Q 0
0
•cg °°.\:.\' --.- ..-°'\ it'"
`411111111111b ,./,l,Send Invoice To: ,f
ifi
J
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT
?-Z-Z-5- ___C-P1___C-P1 I AMOUNT
?-Z-Z-5-
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
SHIPPING INSTRUCTIONS • VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERaIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
• SHIP REPAID. THIS APPROPRIAT ON,SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. r - B
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 - ,�/�d�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE °"_"—
CLERK-TREASURER
DOCUMENT CONTROL NO. 26463 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE