25290 American Structurepoint City o Carmel IRTIFICA RENO. TAX 0155 00 PAGE
,11r \�/ CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 2-S-29 a
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,AIP
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 7Z-IO0 S TO
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CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
p !,r < ( 20 13
0 0 '•
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P I 4c.a. . ek\aind ii\cr cho
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Send Invoice To: l G. 4 I l I 103 .6'
212_- 4q to2EloS
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 APPROPRI T1ON;SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. TT�l
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LRBELU. A_'
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /,f.�'(,�--.„1 •
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25290 CLERK-TREASURER
DOCUMENT CONTROL NO. OFFICE COPY