HomeMy WebLinkAbout238849 11/05/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 154252
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $*******254.96*
CARMEL, INDIANA 46032 PO 13OX 78588 CHECK NUMBER: 238849
INDIANAPOLIS IN 46278 CHECK DATE: 11/05/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
854 5023990 01196405 254.96 OTHER EXPENSES
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER: 21366 PAGE: 1
OUGENP.O.BOX 78588 INVOICE: 01196405 ORDER: 02037778-00
INDIANAPOLIS,IN 46278-0588 INV DATE: 10/03/14 ORD DATE: 09/29/14
317-290-0003 SALESPERSON: 000 TERR: 005
BRANCH: 001 INT: MMG
P/O:
TERMS:. NET 30
V` SHIP VIA: Our Truck
CRELEASE#:
B S
I CARMEL, CITY OF H CARMEL, CITY OF
� 30 W. MAIN ST. STE.200 P 30 W. MAIN ST. STE.220
CARMEL IN 46032 CARMEL IN 46032
T T
O O
INVOICE AMOUNT: 254.96
rLEASE SEN D-TOPPORTION WITH YOUR PAYMENT--=-------------------------------------
-------- -- -; _ _-uT�' - QTS' -_____ -UN!T - ---_
ITEM .DESCRIPTION UOM `AMOUNT
SHIP'D aro PRICE
** Location: **
HE 200 1 0717, HELIUM BALLOON GRADE 200CF CYL 219.129 219.13
CGA580-NOT FOR INDUSTRIAL USE
200CF @ 109.5645/100CF
FSCFUEL SURCHRG 1 0 TEMP DIESEL SURCHARGE OUR TRUCK EA 4.90 4.90
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 229.98
TOTAL YLINDERS SHIPPED: 1 RETURNED: 1
Visit us on fac book or oi the Delivery Cha ge 24.98
web at wm indi nao gen. om
Taxable amount: 0.00
CARMEL, CITY OF CUSTOMER: 21366 • • 254.96
30 W. MAIN ST. STE.200 INVOICE: 01196405 ,
CARMEL IN 46032 INVOICEDATE: 10/03/14
ORDER: 02037778-00 P/O:
-.INDIANA OXYGEN COMPANY • P.O. BOX 78588 9 INDIANAPOLIS,IN 46278-0588
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen Company, Inc.
IN SUM OF$
l
I
P. O. Box 78588
Indianapolis, IN 46278
$254.96
ON ACCOUNT OF APPROPRIATION FOR
Community Relations Gift Fund 854'
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
$
854 01196405 254.96
1 hereby certify that the attached invoice(s), or
I I Arts District Festivals I
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
S
Mond November 03,2014
I
Director,Community Relations/Econo is Developments
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service,where performed,dates service rendered,by
whom,rates per day, number of hours, rate per hour, number of units, price per unit,etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
10/03/14 01196405 $254.96
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer