26565 TMT Inc. 0 4" INDIANA RETAIL TAX EXEMPT PAGE
City o r Carmel CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2- n C(0 c
35-60000972 w
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 ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. • DESCRIPTION
VENDOR t-i- _)1 ' I PISt' • tC,k SHIP
TO
West/ e\6. ,i`1 4tcc"i-�
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT ,
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: En \�.O_S r■1`S ... ►^- ,,. I 2�,
22Oo - 44(o 2-'I 0I
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
SHIP REPAID:
THIS APPROPRI Q ; 11E5ICIENT TO PAY FO,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 /�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 2 6 5 6 5 OFFICE COPY