26674 Hall Render Killiam Heath & Lymen City 0 C®J,r� ����� INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
DC f/&7l; -F /4 FEDERAL EXCISE TAX EXEMPT / ( /y•�n'/� /✓ v ��� 35-60000972 C7?7 (!�
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
7,47//0 .- .
VENDOR / ` f: 1 SHIP'' / //eit(i
0 79 g&4-e-ebaul- eee, -- TO
( A4 , -7-, . 4069- 9p _
CONFIRMATION BLANKET CONT.ACT / PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
r `'S r & G
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i Al 15P. S�
e,e 1, etel,P146-t)/"2e4-/ ' '' 41-'d6°)
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Send Invoice To: d m• '
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
lGGUJ "0 1?/.3, oo-D PAYMENT ` a2�/.s19 • nv
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
cetia, Pe-e :, NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • IJiEBESY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIA . FFICIENT 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 .1 �(/
_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. _ ' / //
26674 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY