25306 Crossroad Engineers City of Carmel r INDIANA RETAIL TAX EXEMPT 155 00 PAGE
of CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2c 3O\o
35-60000972
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
CYOS&oo.6 Lt 's (1 C _
VENDOR
SHIP , \e�1 o C Eft(Vlf'e.yt v■(�
I 1 C J J
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: �rjfJ�� "" O "�
ri J11�1��; ' 22.oC'o
2o2- yon
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I ' 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 CERTIFYTHAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATU SUFFICIENT 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. / _ �a 4 .
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /�� II'000 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25306 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY