248391 08/12/15 a�%'`�"tf. CITY OF CARMEL, INDIANA VENDOR: 154252
® ,• ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $""'**350.07'
,_�; CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 248391
•�'��roei�. INDIANAPOLIS IN 46278 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 08350457 110.12 BOTTLED GAS
1094 4239012 1311332 239.95 SAFETY SUPPLIES
CYLINDER RENTAL INVOICE
IN.DI-AN./1 INDIANA OXYGEN COMPANY CUSTOMER:07851 PAGE: 1
DUDEP.O.BOX 78588 INVOICE: 08350457
INDIANAPOLIS,IN 46278-0588 INV DATE: 07/31/15
317-290-0003 SALESPERSON:0 0 0 TERR: 007
BRANCH: 004
P/O:
TERMS: NET 30
6 CARMEL STREET DEPT H CARMEL STREET DEPT
�
3400 W 131ST ST P 3400 W 131ST ST
CARMEL IN 46074 CARMEL ,IN 46074
T T
O O
INVOICE AMOUNT: 110.12
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
rwv - -- 'ITEM INVOICE DATE INVOICE - .BEGINNING.. SHIPPED. RETURNED -ENDING LEASED -BAUDAYS. .CYLINDER EXTENDED;
_ P BALANCE BALANCE - CYLINDERS RATE -'AMOUNT
-
R ALY ACETYLENE 3 0 0 3 0 93 .429 39.90
R ARG ARGON 1 0 0 1 1 0 .389 .00
R CMF ASSET MANAGEMENr FEE 0 0 0 0 0 0 9.92 9.92
R CO2 CARBON DIOXIDE 1 0 0 1 0 31 .389 12.06
R MIX MIX GASES 2 0 0 2 0 62 .389 24.12
R OXY OXYGEN 2 1 1 2 0 62 .389 24.12
TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851TOTAL110.12
' . :
3400 W 131ST ST INVOICE: 08350457
CARMEL IN 46074 INVOICEDATE: 07/31/15
TOTAL CYL VALUE: 2700.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588 9 INDIANAPOLIS, IN 46278-0588
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF$
P. O. Box 78588
Indianapolis, IN 46278-0588
$110.12
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
2201 I 08350457 I 42-311.00 I $110.12 I hereby certify that the attached invoice(s), or
bills is are true and correct and that h
O (are) atte
materials or services itemized thereon for
which charge is made were ordered and
received except
Trsd s 2015
Ms
St '
t�t�tener i
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
f
1
h
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))
- . 07/31/15 08350457 $110.12
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
-- _nN ._i.f.1TY-- --- -- �r...c,ir.'+..ei - - - -I_iiiee >rtnanllnlT—.r,�
-- -- -— -
11 Clvl v 'JVnlf I IV�v Vvlrl
UNIT_
SHIP'D sro. . , , PRICE
** Location: **
OX AD 7 0 7 6 OXYGEN, COMPRESSED 2.2 CYL 29.073 203.51
UN1072 (USP GRADE)
105CF @ 193.8200/100CF
j ENTER LOT NUMBER ABOVE
Lot: D0756101 Q--y: 7
FSCFUEL SURCHRGI 1 0 DIESEL SURCHARGE OUR TRUCK EA 3.51 3.51
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subto al 212.97
TOTAL YLI ERS SHIPPED: 7 RETURNED: 6
Visit us on fac book or oi the Delivery Cha ge 26.98
web at wwjr.indi naox gen. om
Taxable amount: 0.00
CARMEL CLAY PARKS CUSTOMER: 03390 ° 239.95
1411 E. 116TH ST. INVOICE: 01311332 ,
CARMEL IN 46032 INVOICEDATE: 07/20/15
ORDER: 02170922-00 P/O: TERESE
INDIANA OXYGEN COMPANY • P.O. BOX 78588• ,INDIANAPOLIS, IN 9 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
7/20/15 1311332 Oxygen tank refills xx2565 $ 239.95
Total $ 239.95
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
ti
Voucher No. Warrant No. f
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 239.95,
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
f
ti
Po#or + Board Members
Dept# INVOICE.NO. CCT#/TITL AMOUNT
1094- 1311332 4239012 $ 239.95 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 .
August 6, 2015
Iti
$ 239.95 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund