241309 01/22/15 CITY OF CARMEL, INDIANA VENDOR: 154252
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $*******252.62*
CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 241309
INDIANAPOLIS IN 46278 CHECK DATE: 01/22/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 01230046 241.49 OTHER EXPENSES
1094 4239012 8320218 11.13 SAFETY SUPPLIES
IIIIIELUL
-- -- ITEM - 1- SQi�o- B�-- -----� -____DESCRIPTION_ _IJOM_. _ _ _ UNITPRiCE _. AMOUNT -
** Location: **
MIP192048 5 0 ELECTRODE EXTENDED (5PK) ICE40 EACH 9.80 49.00
ICE55 TORCH 625XTREME 2050/
MIP192052 5 0 TIP EXTENDED 40A. (5PK) ICE40 EA 4.88 24.40
ICE55 TORCH 625XTREME 2050/
** Location: A **
AC 75/25 1 0 1 1 ARGON,CARBON DIOXIDE 75/25 384CF CYL 78.042 78.04
INDUSTRIAL GAS MIX CGA580
384CF @ 20.3234/1000F
KISKC2803544 44 0 70S6 .035 X 44# SPL LB 1.82 80.08
70S6035X44 #SPOOL
** Location: w **
FSCFUEL SRCHGWCJ 1 0 TEMP DIESEL SURCHARGE W/C EA 4.02 4.02
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 241.49
OTAL �YLIIIIDERS SHIPPED: 1 RETURNED: 1
Visit us n fac book or o the
web at .indi naox gen. om
Taxable amount:l 0.00
CARMEL WATER CUSTOMER: 12598 71 rsrTm 241.49
3450 W 131ST ST INVOICE: 01230046
CARMEL IN 46074-8267 INVOICEDATE- 12/31/14
ORDER: 02077706-00 P/O: STEVE
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
VOUCHER # 142725 WARRANT# ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278 ?
r
Carmel Water Utility i
ON ACCOUNT APPROPRIATION FOR
17-
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
01230046 01-6200-06 $24.1.49
o-
,
Voucher Total $241.49
Cost distribution ledger classification if
claim paid under 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 bero erl itemized must show, kind of service, where
p p Y
rates number of units
performed, dates of service rendered, by whom, tes per day, ,
price per unit, etc.
Payee
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 12/30/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201, 01230046 1 $241.49
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
Date Officer
NV ITEM INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING EASED BAUDAYS_ CYLINDER EXTENDED
-- P - --BALANCE- -BALANCE- C UNCERS RATE -- -AMOUNT-
- - -
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .359 11.13
TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL 11.13
1411 E. 116TH ST. INVOICE: 08320218
CARMEL IN 46032 INVOICEDATE: 12/31/14
TOTAL CYL VALUE: 100.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588 9 INDIANAPOLIS, IN 46278-0588
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
154252 Indiana Oxygen Company Terms
P.O. Box 78588
Indianapolis, IN 46278-0588
Invoice invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/31/14 8320218 Oxygen tank rental 36390 $ 11.13
Total $ 11.13
1 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
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588 i
� In Sum of$
I
$ 11.13
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
I
PO#or Board Members
Dept# INVOICE NO. ACCT#MTLE AMOUNT '
1094 8320218 4239012 $ 11.13 1 1 hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
f materials or services itemized thereon for
which charge is made were ordered and
received except
I
I
January 15, 2015
5
$ 11.13 Accounts Payable Coordinator
Cost distribution ledger classification if i Title
claim paid motor vehicle highway fund
i
I