26697 Process for Indentification INDIANA RETAIL TAX EXEMPT PAGE
c:it of C sane l CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBE SE FEDERAL 5X 010 0972 EXEMPT K 1
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 REQ.IRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR �'nG� I ` v SHIP �,/� Oat( -- , o x(4093(:).1_ r .1 it cyf A
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice !� l ° l�
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PLEASE INVOICE IN DUPLICATE
DEPAPITMENT ACCOUNT PROJECT PROJECT ACCOUNT .. / AMOUNT.UC_
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Toó 6 PAYMENT ��• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A ART OF THE)OUCHER AND EVERY INVOICE AND
,..,NUMBER
HAS TH PROPER S ORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEgEBY CERTI THAT TH IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THfS APPROP AT_SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY \
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ' L'r—e
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
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