20006 The Hill Company City ® Carmel INDIANA RETAIL TAX 015500 PAGE /
111r CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT � r
■ 35-60000972 �OCJC/(Q
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,ANP
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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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
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QUANTITY UNIT OF MEASURE I DESCRIPTION, UNIT PRICE EXTENSION
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Send Invoice To: ��-0 6\q-.1 0,p7
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PLEASE INVOICE IN DUPLICATE
DEPARTMENT '' ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
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/0707 "7`01 S-0 e-CCD 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 THALTHERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION MCI T.7f0 PAY FOR THE'A,BOVE ORDER.
•SHIP REPAID. • -
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. it . ,i. , /-' a,
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY •
SHIPPING LABELS. II�����\`.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99.ACTS 1905 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2000 6 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY
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