26663 Barnes & Thornburg LLP 0 INDIANA RETAIL TAX EXEMPT PAGE
®J� Car me l CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER •
06-197-mb-7vr �/J_, ) EXCISE TAX EXEMPT / /�3
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
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VENDOR //,��� / ' .0-t41-11- TO
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: ' ..
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
AU,0 I/ O D 130"' /56(Pe--'2�D(� PAYMENT # 0257.57
C / 2lj • A/P VOUCHER CANNOT T F THE VOU FOR PANDE V RY INVS CE P.O.
(� /J 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
SHIP REPAID.
THIS APPROPRIATI.N SU T TO PAY FOR THE ABOVE ORDER.
•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 ...
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. / g .
CLERK-TREASURER
DOCUMENT CONTROL NO."2.6 6 6 3 OFFICE COPY