26706 Nelson Alarm, Inc. C1 ,. INDIANA RETAIL TAX EXEMPT PAGE 1 I
- l of Car e 1 CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2._b201
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
I C
VENDOR �.-Z, } 5.5 ca- SHIP �},� : �'i�^^ -��c���1
TO Off- C• t,.
CONFIRMATION BLANKET - CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1
2jL:4s 1 ->-))14. \4-b --TC c, s s,v,cvv- R`_,x cc.lds S. as- ) o5U
S
10_,_2-1-- --AdIr* -" --Ap..,
4 F
�` .
' .ate
4Ilkit
gam '"
r.iii , , I, ._Ap 0,
L-1 * : a -4_ i, * *1 k
(11; Aittil
,0 . 0
'\'''4410W%‘i4Z ''''''"'Vj -!, )
.Send Invoice To: U (
l
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
)2,..6.- ____3-0?-- PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE? ART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS TilE ROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTI ATTHEREJSAN UNOBLIGATED BALANCE IN
THIS APPROPRI.a O S PFZIEW TO PAY FOR THr ABOVE ORDER..
• SHIP REPAID.
n
•C.O.D.SHIPMENTS CANNOT.BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. .4"..........:
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Y)1�Y1VA�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO..
DOCUMENT CONTROL NO. 26706 CLERK-TREASURER
OFFICE COPY