26314 CPI Supply 't i
A
•i 1, '1.1. ,, I ,t,IaNDIANA RETAIL TAX EXEMPT PAGE
C 1 ® C°,�rine i ' p �t�G Rt'1`iFICATE AO.0031.20155 002 0
����////ls+s 1� � i PURCHASE ORDER NUMBER
• FEDERAL EXCISE TAX EXEMPT 26314
35-60000972 .
•
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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
12/12/2012
CPI Supply Street Department
VENDOR 2900 Mitchell Road SHIP 3400 W. 131st Street
P.O. Box 249 TO Carmel, IN 46074
Bedford, IN 47421 (317) 733-2001
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION r UNIT PRICE EXTENSION
• Account
6, S5G, 0D
Each
Sub Total:
0 1,14_ G. J
P; . ( Al r , • `P I^
•
a
P ,pp/yy
` °•jj•ppyyi I 0f�•. F.
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t 1 J
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4o •,..••.. -
.' 6
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end Invoice To: '.,_.��
_ _ ' 1 — 414 la 3O0
Street Department q, 1-
3400 W. 131st Street L of �'�e I n d
C ,IN 46074- .v Iv I(V1�1
n,��
arme
'_PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Street Department '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 THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFIHAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATr bFF CIENT 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 /4,4--.....—.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. j '
2 6 3 ' CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY • .