31553 Ben Hur Construction PAGE
City Carmel CERTIFICATE NO.003120155M 02 0 PURCHASE ORDER NUMBER
`�' �T ��// �1r 1111 FEDERAL EXCISE TAX EXEMPT /j' / 3
5 G
35-60000972
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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
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PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO, DESCRIPTION
fell Hui- (on 5`�T (1I Oh Cu• SHIP C R C
VENDOR V()x 22_ 3(-15
TO
30 W. MAIN s-I., S�liP 220
TnJiankp0l1s,jJY x{ 6222 0\rme\ ,T!✓ 46032
I CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT '-
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Chilli'? order .. Co I" It} rP,-1 9441Ye $ 2 22 g,Wu
kvork re View) for PAIIdiuIv S1eeJ
.#$$Tj0.....9.- ....;iv "Ire
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Send Invoice To: R� 0
c ea if Jl1j�.
iO w Plalh- -SI., SNIe 22 0
( rniel ,T_4/ 46032
•
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I,' LACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
C1 OZ 446 007 . PAYMENT
I • NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
I 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. ORDERED BY lig _c
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ,/
. SHIPPING LABELS. l //
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE f {//��,(—�, —,
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 31553 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE