244724 4 /29/2015 ' 4,pb€� CITY OF CARMEL, INDIANA VENDOR: 154252
j ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $********90.46*
r q CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 244724
°M;ron�:s INDIANAPOLIS IN 46278 CHECK DATE: 04/29/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 01273763 90.46 BOTTLED GAS
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
01WORP.O.BOX 78588 INVOICE: 01273763 ORDER: 02128595-00
INDIANAPOLIS,IN 46278-0588 INV DATE: 04/16/15 ORD DATE: 04/16/15
317-290-0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: JRB
P/O:
TERMS: NET 30
SHIP VIA: Will Call
RELEASE#:
I CARMEL STREET DEPT H CARMEL STREET DEPT
�
3400 W 131ST ST F 3400 W 131ST ST
CARMEL IN 46074 CARMEL IN 46074
T T
O O
INVOICE AMOUNT: 90.46
------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
L. mcnA QTY -. ,QN v''"D S I —� '!O"A" I___ e rviT nnnnimlr .
- SHIP'D BIO .- - , - , � PRICE
** Location: **
AR 336 1 0 1 1 UN1006, ARGON, COMPRESSED, 2.2 CYL 81.585 81.59
336CF @ 24.2813/1000F
FSCFUEL SRCHGWC 1 0 DIESEL SURCHARGE W/C EA 2.92 2.92
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtollal 90.46
0TAL _'YLTNDERS SHIPPED: 1 RETURNED: 1
1
I I
Visit us at fac book or oi the
we at wm .indi naox gen. om
Taxable amount: 10.00
CARMEL STREET DEPT CUSTOMER: 07851 AMOUNT 90.46
7HIS�.INVOICE
3400 W 131ST ST INVOICE: 01273763 'INCLUDING
CARMEL IN 46074 INVOICEDATE: 04/16/15
ORDER: 02128595-00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF$
P. O. Box 78588
Indianapolis, IN 46278-0588
$90.46
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members
2201 01273763 42-311.00 $90.46 1 hereby certify that the attached invoice(s), or
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
i
i
411 Th rsd r'I2 015
A 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.
j Terms
I Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
04/16/15 01273763 $90.46
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