31797 REI Real Estate Services C �1111 ty of Carmel INDIANA RETAIL TAX EXEMPT PAGE
111E CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3/797
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
VENDOR l L. T Heal E %'ale / e'r ii
// SHIP (/X
H7N N l'enn>ylrrnn,n 5u/1s 200 TO 36 W 4' 5/ , Su� �P2 (JO
•
/ rrnei, T N LI40yZ (dyhlrl,TY /4102.
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Or. %......
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Send Invoice To: (R �f (Jj
3U l^/ Ai) 51- , 5a+4-0 22 j)
(trine!, T g yo032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT C{/O'U'NT PROJECT PROJECT ACCOUNT AMOUNT
/ SO/ /? SO / 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 THAT THERE IS AN UNOBUGATED BALANCE IN
THIS APPROPRIATIO UEFICIENT TO PAY FOR'THE ABOVE ORDER.
•SHIP REPAID. [///—
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY '" , c-
I •PURCHASE ORDER NUMBER MUST APPEAR ON ALL /
SHIPPING LABELS. '/
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
' - -ANDACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
.=___
CLERK-TREASURER
teeL
DOCUMENT CONTROL NO. 1 9-7. ,.. A.P_v.-copy ,SIGN AND RETURN TO.CLERK'S OFFICE