26496 PKS Construction Inc. JJJ ��4 INDIANA RETAIL TAX EXEMPT PAGE /
ofCarmel l CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
111111
FEDERAL EXCISE TAX EXEMPT 6 /
35-60000972 p( �7-/ /9(Q
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
)00/10/j _/L ) Ov7/1/1-040
VENDOR ,/50 L5-,,,,,ti/ �_ I C, SHIP TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION �� /� UNIT PRICE EXTENSION
672 ‘46) beeso L<� 1t�:wlFV lei"`4
1 4p,‘e-3
0 ' - '1 '
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:4, ., 141i:. A '
0: , 4\ .4 . ,,,,,,,, %I"
viiik ..,J/(}J� ,S'?' as ;,:.�3
4: ...4,-- 45
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NAP- 9 c 0,
Send.Invoice iii
PLEASE INVOICE IN DUPLICATE )/ 4.p 483,
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
f Z- OS 50 / 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
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT VERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFIC TO'5AY FOR THE ABOVE OVER
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. •
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE j • .
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
264 9 6 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY
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