26718 West Publishing 0� ® 'l j fr,; E PAGE
City �I � � INDIANA RETAIL TAX EXEMPT CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
A 0 FEDERAL EXCISE TAX EXEMPT
Affm-2-20e-iu7- 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
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VENDOR 0�Y SHIP
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: ` / , 1
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
/DyeAket,e(7,11) '4/0 —l 7e■ 0 PAYMENT ., > ' / 7 96. O6
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
OP �� Pflibt.444e--- 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
•SHIP REPAID.
THIS APP;•-; • • SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �11�'
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL i_
SHIPPING LABELS. I QA��
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE -wa /,i /
AND ACTS AMENDATQRY THEREOF AND SUPPLEMENT THERETO. `���' /
CLERK-TREASURER
DOCUMENT CONTROL NO 2671.8 OFFICE COPY ;