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29291 Carmel Clay Schools (2) PAGE INDIANA City 0 Carmel. CERTIFICATE NO.003120155 5 0 2 0 �1 f �!!lk✓E Sys PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 29291 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 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 12/18/12 N/A 04{25% Equip .T 1. Carmel Clay Schools Maint DEC 1 8 2012 I VENDOR 520 / E• /14 .�Q .A SHIP TO _ ._e+OVInd JAL 46032 _ , CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION I UNIT PRICE l EXTENSION 1 EA Diesel Fuel $200.00 $200.00 1 EA Gasoline Fuel $1,200.00 $1,200.00 . Send Invoice To p0 0. 0) PLEASE INVOICE IN DUPLICATE $1,400.00 DE ARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1125-4-01-4231300/423140Q-Diesel/Gasoline 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 SWORD AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS/N UNDBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TD PAY FOR THE ABOVE ORDER. •SHIP REPAID. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. Michael Klitzin - DK •J •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY g �� T\Q ` (Z 1(�I Z SHIPPING ORDER ISSUED i ! 4 y nt L •THIS ORDER ISSUED IIJ COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE !, AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. / Pr- 29291 CLERK-TREASURER DOCUMENT CONTROL NO. VENDOR COPY