245519 05/20/15 CITY OF CARMEL, INDIANA VENDOR: 154252
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $********l 2.87*
f r4 CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 245519
9M,_roN.�o: INDIANAPOLIS IN 46278 CHECK DATE: 05/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239012 8337317 12.87 SAFETY SUPPLIES
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END
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IM' ITEM INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED BAUDAYS CYLINDER EXTENDED
BALANCE BALAN_C_E _ CYLINDERS RATE - AMOUNT
R CMF ASSET MkNAGEMENr FEE 0 0 0 0 0 0 1.20 1 .20
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 30 .389 11.67
RE
MAY 06Z15
I
TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ®T-
12 ' 87
1411 E. 116TH ST. INVOICE: 08337317
CARMEL IN 46032 INVOICEDATE: 04/30/15
TOTAL CYL VALUE: 100 . 0 0 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• 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
4/30/15 8337317 Oxygen tank rental Apr'15 xx1689 $ 12.87
Total $ 12.87
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
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 12.87
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 8337317 4239012 $ 12.87 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
May 14, 2015
$ 12.87 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund