26583 Electro Painter Midwest Ci o fINDIANA RETAIL TAX EXEMPT PAGE
C armel CERTIFICATE NO.003120155 002 0
t'y lvs1� 1i PURCHA ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 (41-53
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 t �lJ�-J
4._,,dt.k} 470d LlS I A-) TO
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CONFIRMATION pBBLLAANNNKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
41FACIfe„ t '94/Y'D'°2")
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Send Invoice To: ,; r� )' , -1, ,Q®Q /'�
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0 4 LI1,O3 - 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 HER.:Y CERTIFY THAT THERE IS A NOBLIGATED BALANCE IN
THI PROPRIAT N S FICIENT T f •AY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. \'
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY "9
SHIPPING LABELS. 4�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
, Li&fitLiu4z.etz<J,L.
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. //
6 5 3 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY