31727 Americann Law Institute CAQ..�� INDIANA RETAIL TAX EXEMPT PAGE
ity ® 1.,�\ ,arms I' CERTIFICATE N0.003120155 002 0 PURCHASE ORDER NUMBER
-r- (+N'-Q l I of La LJ �v/a FEDERAL EXCISE TAX EXEMPT 2 ) -7O R
NI-1� 1 35-60000972 �I
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AM
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 SHIP
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURES DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To: �f - Off
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT g� AMOUNT /1
,1_, ,,,3 II0 p0 435706I/ PAYMENT -01JzJ 1. 00
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
1-45/ 0Ct]On LCI s NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
r I VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. - e-
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY _�
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SHIPPING LABELS. • /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 1-t V r I 1}✓n� )
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 31727 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE