26593 Sungard Public Sector City ®f C�1rel IRTIACA RENOL TAX EXEMPT PAGE
CERTIFICATE NO. TAX EXEMPT PT 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �(Y 3
35-60000972
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
'URCHAS ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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VENDOR iii,)/J a-% ,' Jy- 'I/ ! // " '-- v/ ;J / SHIP d 1 / ) C itd-n L.-
ae-0 /�""�51 11146S Ci'l�(/ /"�— TO ��V/C 5
L 4.t%. /l7 Aftyl �2- 3,214/10, 0411 C�v�ci
C411-2r�, T� �ld3 v
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
-
QUANTITY UNIT OF MEASURE DESCRIPTION
UNIT PRICE EXTENSION
S .4 /n/9117/6t/ 1-7-)de_____
a,-y, iy-4-cii-- * 7 keo-
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Send Invoice To: Lis4 frt, S i t co if-i4.4 '= ,
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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 THAT THERE IS AN UNOBLIGATED B`�•NCE IN
•SHIP REPAID. THIS/S /RI.TIO FFICI NT TO AY .- HE Ay. E f Di
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ,
SHIPPING LABELS. �11�'P.U` /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE \ 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
�6 5 9 3 CLERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY