31289 Drewry Simmons Vornehm City o f Carmel INDIANA RETAIL TAX EXEMPT 155 00 PAGE
\\1/.1111 CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
G� r I FEDERAL EXCISE TAX EXEMPT 3 19 Q•
he pa n�n O T h 35-60000972 U
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 -
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO, DESCRIPTION
/D/7f i3
'firmly Simmons Voin-ekm1 zip
VENDOR 73 Lc Nan0Vie('Pla c.e1 54-t, 200 SHIP
TO
Cacmtl , iN N�o3a
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
J_.,e,aI -rest a s PA ( 4c'e)\•ecl $ /, 791153
nvo.iGA. M 910 ILI
Na
a 6) ifri
Y .•
: 4 '-' M G�
Send Invoice To
1
PLEASE INVOICE IN DUPLICATE
DEPARTMENT / ' ACCOUNT PROJECT PROJECT ACCOUNT .ry AMOUNT
)_a(A) I I WO Al 3D -!O0 W PAYMENT '17 °I 1 i 5 D
L- @ a I • NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
.Q. 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 APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ().-l ',}-\P (4- Ip(A ty
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 31289 CLERK-TREASURER
OFFICE COPY