29291 Carmel Clay Schools A INDIANA RETAIL TAX EXEMPT PAGE
1 X1.1't C° m CERTIFICATE NO.003120155 002 0
V11� C�.�S PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 29291
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
12/18/12 N/A 0l/259' Equip •�r-_TAT. a
Carmel Clay Schools Si Maint DEC 18 2(J1z
52b / E. /�1Q,{,n S SHIP
VENDOR h MA Q � �L �
C,G /Y UL J, Li lib 032 TO —...__.. _-..
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION I UNIT PRICE EXTENSION
1 EA Diesel Fuel $200.00 $200.00
1 EA Gasoline Fuel $1,200.00 $1,200.00
Send Invoice To
p0 0�
$1,400.00
V� 7,1\.r- PLEASE INVOICE IN DUPLICATE
DE ARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1125-4-01-4231300/4231400-Diesel/Gasoline 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 SWORD AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS/N UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT lJ PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BEACCEPTED. ORDERED BY Michael Klitzing - DK •i L I ••-` �2- 1,1,-
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL �-----
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE lF Z' L
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. / /
29291 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY