26595 Work Place Solition PAGE
IRTIFIARENLTAX0 C i o f C CERTIFICATE NO.003120155 00 2 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �S ∎ -- -
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
'URCHASE RDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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(03-y' Ggce-- h c
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VENDOR 9/ f ( L i V.-CLAY AL,d• IL) SHIP C/i� (�, -1--y �'f►
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
OFF( CPI 4-1 rS c4 1710-() ; 1 /6,( - '(-)
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Send Invoice To: �,i. STuu)14 ril.—
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14(90,52. - 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
VOU ER HAS THE PROPER SWO'7AFFIDAVITATTACHED.
SHIPPING INSTRUCTIONS • I j:Y ERTIFY T AT THERE IS• UNOBLIGATED BALANCE IN
SHIP REPAID. TPROP SUFF IEN 'O PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY Oa / ! 'f or 7
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. A // ' l•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE .. 1 i , '
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. //
DOCUMENT CONTROL NO. 2 6 5 9 5
CLERK-TREASURER VENDOR COPY
OPY