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t of Car a CERTIFICATE NO.003120155 002 0
Dfl PURCHASE ORDER NUMBER
re�Ji t/T 4-rs' / FEDERAL 35-60000972 1 EXEMPT d6/n/7D
ONE CIVIC SQUARE . THIS NUMBER MUST APPEAR ON INVOICES,/VP
CARMEL, INDIANA 46032-2584..,/// VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF AECOUNTS FOR CITY OF CARMEL-1997
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'URCHASE ORDER DATE DATE REQUIRED / REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR
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0 TO
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CONFIRMATION BLANKET CONTRACT / Y•• PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
77?C'1A, ' it ,, any DO
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Send Invoice To: ) R
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
a aor .9a°- 3D/DD PAYMENT any o� .
datufri7oT ' • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
/•t:/(.�cA �/ 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
T�iISAPPfi•” • •` b NT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY -
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE j1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
C
CT
LERK-TREASURER
DOCUMENT CONTROL NO. 2 s w 7 n OFFICE COPY