25299 American Structurepoint C O o C arme1 INDIANA RETAIL TAX EXEMPT 155 00 PAGE
Clay 11Lr CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE AX EXEMPT 2c 29
•
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
' 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
AnkeV.tctiY YU.c-kwe"30AA SHIP \\ O 1 (t [ •
VENDOR 72(00 S e„ \ SfnllOn TO `-'�KT- OT ter l An-V, v-Ts_.
Zode1S , Lla 4b2S10
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
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Send Invoice To: L T l -(
j J s9, Leo.. aQ
• 212- 441,9-NI s
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 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 CERTIFY THAT/.THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICE T TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•ton.SHIPMENTS CANNOT BE ACCEPTED. i,. / . • .
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. /- /` _/
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE //���' °°/�-T/�-----N
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT. THERETO,
20 2 99 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY