242760 03/03/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 154252
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECKAMOUNT: $********31.90*
CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 242760
INDIANAPOLIS IN 46278 CHECK DATE: 03/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 01245297 31.90 OTHER EXPENSES
UNIT
S
-I tlVl v�JCni?Tw?v— - I PRICE`
nrHIP'D B!0
** Location: **
CD 50RB 1 0 1 1 CARBON DIOXIDE, 2.2 CYL 22.964 22.96
UN1013 (LIQUID WITHDRAW)
50CF @ 45.9280/100CF
FSCFUEL SRCHGWCI 11 0 DIESEL SURCHARGE W/C EA 2..99 2.99
HMCHAZ MAT CHG I 11 01 HAZARDOUS MATERIAL CHARGE EA. 5.95 5.95
Subtotal 31.90
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40TAL I'YLINDERS SHIPPED: 1 RETURNED: lI
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Visit us in fac book or on the
web at wwTjr.indi maox rgen. --om
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Taxable amount: 0.00
CARMEL WATER CUSTOMER: 12598mail
Ems
31.90
3450 W 131ST ST INVOICE: 01245297 ,
CARMEL IN 46074-8267 INVOICEDATE: 02/09/15
ORDER: 02096027-00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 9 46278-0588
j VOUCHER # 151038 WARRANT# ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
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Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1
01245297 01-6200-06 $31.90 j
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Voucher Total $31.90
Cost distribution ledger classification if
claim paid under vehicle highway fund
1
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 2/23/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
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2/23/2015 01245297 $31.90
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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
Date Tficer