26580 JB:MJM of Indiana, Inc. INDIANA RETAIL TAX EXEMPT PAGE
City ®� Carmel CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
•
FEDERAL EXCISE TAX EXEMPT 2(000
35-60000972 O
ONE CIVIC SQUARE •k 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
X2120
T g TM be .1 c V\O ) INC-
+10 v■L■At■ /kv� 5,�∎&,. \ZDO SHIP \ n •VENDOR TO 1�f' Qt' ENC 1 Y\.9 ca V I vIQ
Vm 1 wa��e, , w t c�2G3 J
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS - FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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•Send Invoice To: J O °D •
+(e lease. •G n 2:3-4R0
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT, PROJECT . PROJECT ACCOUNT AMOUNT
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 CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN ;•.
< THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
SHIP REPAID.. //r
•
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•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY ( / r '�
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL. _ / U ;�i-
SHIPPING LABELS. / ^
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE / 1/1 1 7
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. { ���
CLERK TREASURER ;
DOCUMENT CONTROL NO. 6 0 OFFICE COPY �'