26582 Workplace Solutions INDIANA RETAIL TAX EXEMPT PAGE
City ®f C sane l CERTIFICATE NO.003120155 002 0
Carmel PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT deeL -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 ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR /�
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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: _ ,` ) vi (0)�` oG J /)a/
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1 orb. 4.57)3-43
0,,, (PO3 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 S N AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HE. Y CE IFY T T THER AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
T PROPR SUFFICI T TO PAY FOR 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 ∎4; w, ti//L J , i "73 --
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. //
CLERK-TREASURER
DOCUMENT CONTROL NO. 6 8 2 VENDOR COPY