29274 Fifth Third (IPRA) A INDIANA RETAIL TAX EXEMPT PAGE
City ��eu( Carmel CERTIFICATE NO.003120155 002 0
S `.s L� PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 29274
35-60000972
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12/14/12 N/A 61035z83,2— Membership Dues
Fifth Third (IPRA) AO
VENDOR P.o' ow -7'/()"523 SHIP
��✓lC!l�V>a 7' p/t TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 EA Membership Renewal 2013 - Michael Klitzing $244.00 $244.00
•
•
is
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Send Invoice To
$244.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT I AMOUNT
1125-1-01-4355300-Organization & Membership Dues PAYMENT
1-135.5 :)0 • A/P VOUCHER CANNOT BE APPROV:D 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 CERTIFY THAT THERE IS/N UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•G.O.D.SHIPMENTS CANNOT BE ACCEPTED. <
ORDERED BY Michael Klitzing - DK ( j- � 71I,{Ii?
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. //
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1945 TITLE Li4d IL //L
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. '—IT-
29274 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY