26574 American Structurepoint C0 INDIANA RETAIL TAX EXEMPT PAGE .
ity ® I' Carmel CERTIFICATE NO.003120155 002 0 •
1i PURCHASE ORDER NUMBER•• FEDERAL EXCISE TAX EXEMPT (�
•
2(� 4 35-60000972 1
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
•
AllUY.COSt S uc (e e:k-r- SHIP �7k - 0 EY) 1 AQSL)✓;v) .
VENDOR
TO
•
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
■
' . CDIVI/AHVa,i Ol7:-A'' . \ . kt :
. 4 ,-- c 6 no-- 400...
. 00 1 ..9. 7;--...... .,:„0.4 1,2
, / ,,,,,, ....0 V k-) .".:‘ //c\\\—<-7-1A---) 03
. r.., ti;.\.\S:i, -----‘
. A' ‘'(‘(\(\ t' VV:d.: 11'41114,,I■krUkc1/4(-e_. V_e j 0 i
• . `HO v ' ,I'� L\7/ — . E Pc •
. „..., .. .
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. • H--t,,,,r----t' ' '..„. 0 0 ‘,, '
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\400.:c2 '‘.... .--.° c .
°° °•...° °0 ' �7 N`E. •
Send Invoice To: •
••
21t- 41lo2--ZO0
•
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/THATTHERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA ONSUFEIGIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. / } '•
•'C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ./ '
ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL /�/�
SHIPPING LABELS. ! 7'1' /4 1
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 • TITLE V(/� � y�
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. °
CLERK-TREASURER • . -
DOCUMENT CONTROL NO. 2 6 5 7 4 OFFICE COPY •