26591 City of Carmel INDIANA RETAIL TAX EXEMPT PAGE
Ci ®f C°�}� (�� CERTIFICATE NO.003120155 002 0
l�.�s1� �1.�1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �-/a /
35-60000972 `J
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP
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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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• NP 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 TFTATTHERE IS AN UNOBLIG•TED BALrA E IN
THIS PRIATION FICIE TO AY • E AB•,(ORDER.
• SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. t ) � DO ^
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE \J
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
�6 5 9 1 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY