26714 Ogletree Deakins 1,0 INDIANA RETAIL TAX EXEMPT PAGE
i ®f �(/1 rme i CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
Tar ( FEDERAL 5X 010 0972 EXEMPT J DOW<
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
URCHA//SE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
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aleeT,..c. :VENDOR SHIP
TO
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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C 9 C I g ,
,, PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
A' '() / eo. 430 000D PAYMENT >F(0,/J a .Q6
C'_ 1 "°`-/ • NP VOUCHER CANNOT PART OF THE FOR PAYMENT INVOICE THE P.O.
�WQ/�/ 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 BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID ...
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY `1.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL - -
SHIPPINGLABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE .....AC . -Ar-•% ,L. / ;
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. f
CLERK TREASURER t
DOCUMENT CONTROL NO. 7�, OFFICE COPY '