245173 5 /13/2015 CITY OF CARMEL, INDIANA VENDOR: 154252 ....,.. „
CHECKAMOUNT: $ 291.22(9,
ONE CIVIC SQUARE INDIANA OXYGEN COCARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 245173
INDIANAPOLIS IN 46278 CHECK DATE: 05/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 01278470 184.66 BOTTLED GAS
2201 4231100 08337626 106.56 BOTTLED GAS
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER:
:
STO ER: 012
P .O.BOX 78588 78470 ORDER: 02133790-00
INDIANAPOLIS,IN 46278-0588 INV DATE: 04/28/15 ORD DATE: 04/28/15
317-290-0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: JRB
P/O: SHOP
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: 184.66
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
- —nT-Y— -QTv— -----DESCRIPTION-- �_�— �UIVIT —AMOUNT----
ITEM - "— SHIP'D BioUOM PRICE
** Location: D **
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
HAR404318X36 10 0 4043 1/8X36X10# PK ALUMINUM TIG LB 5.13 51.30
ROD 40431/8X36X10
MAY BE HARRIS OR ALCOTEC.
MIP263349 1 0 MILLER TIG GLOVE - XL PR 23.00 23.00
TIL1426XLC 2 0 XL IMP GRAIN COWHD,KS DRVRS-BULK PR 9.95 19.90
Subtotal 184.66
0TAL '_YLINDERS SHIPPED: 1 RETURNED: 1
Visit us t fac book or oi the
web at .indi naox gen. om
Taxable amount: 0.00
CARMEL STREET DEPT CUSTOMER:' 07851 • 184.66
3400 W 131ST ST INVOICE: 01278470.
CARMEL IN 46074 INVOICEDATE: 04/28/15
ORDER: 02133790-00 P/O: SHOP
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
CYLINDER RENTAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER:07851 1 PAGE: 1
P.O.BOX 78588 INVOICE: 08337626
INDIANAPOLIS, IN 46278-0588 INV DATE: 04/30/15
317-290-0003 SALESPERSON:0 0 0 1 TERR: 007
BRANCH: 004
P/O:
TERMS: NET 30
B CARMEL STREET DEPT H CARMEL STREET DEPT
�
3400 W 131ST ST P 3400 W 131ST ST
CARMEL IN 46074 CARMEL IN 46074
T T
O O
INVOICE AMOUNT: 106.56
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
INV _ITEM=--_-_INVOICE DATE.-_INVOICE-.-__ BEGINNING SHIPPED RETURNED_ENDING LEASED BAUDAY CYLINDER EXTENDED
--" 7 '-'-"'" BALANCE--- BALANCE---CY:INDEF',,.-- -RATE----AMOUNT--
R ALY ACETYLENE 3 0 0 3 0 90 .429 38.61
R ARG ARGON 1 2 2 1 1 0 .389 .00
R CMF ASSET MANAGEMENT FEE 0 0 0 0 0 0 9.60 9.60
R CO2 CARBON DIOXIDE 1 0 0 1 0 30 .389 11. 67
R MIX MIX GASES 2 0 0 2 0 60 .389 23.34
R OXY OXYGEN 2 0 0 2 0 60 .389 23 .34
TAX: .00
i
CARMEL STREET DEPT CUSTOMER: 07851TOTAL lot. 106.56
3400 W 131ST ST INVOICE: 08337626
CARMEL IN 46074 INVOICEDATE: 04/30/15
TOTAL CYL VALUE: 2700.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588
VOUCHER NO. WARRANT NO.
Indiana Oxygen ALLOWED 20
IN SUM OF$
P. O. Box 78588
Indianapolis, IN 46278-0588
$291.22
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 01278470 42-311.00 $184.66
I hereby certify that the attached invoice(s), or
2201 08337626 42-311.00 $106.56 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
� TA/.r!d 15
Stmet Cammi!§91aw
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))
04/28/15 01278470 $184.66
04/30/15 08337626 $106.56
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