26558 American Structurepoint i
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urty1f CERTIFICATE NO.003120155 002 0 pURCHASE`ORDER NUMBER
. FEDERAL EXCISE TAX EXEMPT �` �-^'
35-60000972 l 9 J
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 . /"' ,,
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. r" DESCRIPTION
)Cllr-la
VENDOR
SHIP
`. J • CC X1(1�/l�9 ✓i ft
O
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY . UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
•
PAS
. • i\ - ,• •61'.5 V,k,-9•_LV, '..-<-'- •
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•
Send Invoice To:
9Z6 —417-010 �
PLEASE INVOICE IN DUPLICATE
DEPARTMENT • ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1 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 CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE-IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. ... .
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED..
. • PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. •• •
•THIS ORDER ISSUED IN WITH CHAPTER 99,ACTS 1945 - TITLE
AND ACTS AMENDATORY THEREOF•AND SUPPLEMENT THERETO. ,
DOCUMENT CONTROL NO. 26558 CLERK—TREASURER
OFFICE COPY