26563 Calumet Civil Contractors City Carmel i INDIANA RETAIL TAX EXEMPT PAGE
01 C CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2K(0 9
35-60000972
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
1\k 1 IZ
0_0..V.,10(1M.:4 C V\\ Co■(VAVack-o►�
�+, �i l� --C)v-s% SHIP '> . OP EO 1 YLQ9LV 1✓I
VENDOR b U Fleq JIL�1�. �J1r% ve. TO \
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS - FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
(20
•
- t°2 - o--
; :1\:_c (it
.„. , '-',24), , e,,,A e ',` Ac.:1*'' ,47"-64'1/46: cvev C'k--)'((°` \4°A.k tic '' 4
. iLill$ 1.(fi,, 1, i A .
• °• (czi1> v 2.0k0 - Z41e{t 2.500 - �� .)0
Send Invoice To: — �P ( tj �(I • C,2'i hF: ` 20 to - �Z`f'F co 2 3o O = °
�� � v v; ✓�S � - of s iloa.
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
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 THEE ROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY' ATITH 1 AN UNOBLIGATD BALANCE IN
THIS APPROPRI .ON S FFICIENT TO PAY FORT E ABOVE ORDER.
•SHIP REPAID;
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. - 1 _ . 1 ••
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY /SHIPPING LABELS. ( �j��•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE C'l/ " ` 4
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
® CLERK-TREASURER
DOCUMENT CONTROL NO. 26563 OFFICE COPY