248883 08/26/15 �,; CITY OF CARMEL, INDIANA VENDOR: 154252
® °I ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $**.....121.01*
s ?Q CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 248883
1—:-" INDIANAPOLIS IN 46278 CHECK DATE: 08/26/15
�>ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 01316730 70.83 OTHER EXPENSES
651 5023990 01316951 30.45 OTHER EXPENSES
1094 4239012 8350151 19.73 SAFETY SUPPLIES
INV ITEM INVOICEDATE INVOICE BEGINNING SHIPPF.O RETtIRNED ENDING LEASED gAL/DAVS CYLINDER EXTENDED
TYPEBALANCE BALANCE CYLINDERS RATE AN.0UNIT
R CMF ASSET MANAGEMENT FEE 0 0 0 0 0 0 1. 84 1.84
R SHP SMALL HIGH PRESSURE 1 7 6 2 0 46 .389 17 .89
I I I
TAX: . 00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ® 19 .7 3
1411 E. 116TH ST. INVOICE: 08350151
CARMEL IN 46032 INVOICEDATE: 07/31/15
TOTAL CYL VALUE: 200. 00 P/O:
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
7/31/15 8350151 Oxygen tank rental xx1689 $ 19.73
Total $ 19.73
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
l
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 19.73
ON ACCOUNT OF APPROPRIATION FOR
109 -Monon Center
PO#or Board Members
Dept#
INVOICE NO. CCT#/TITL AMOUNT
1094 8350151 4239012 $ 19.73 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
August 20, 2015
$ 19.73 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ORIGINAL INVOICE
INTMANA INDIANA OXYGEN COMPANY CUSTOMER: 16052 PAGE: 1
P.O.BOX 78588 INVOICE: 01316730 ORDER: 02168499-00
INDIANAPOLIS,IN 46278-0588 INV DATE: 08/03/15 ORD DATE: 07/13/15
317-290-0003 SALESPERSON: 000 TERR. 005
BRANCH: 004 INT: JRB
P/0:
TERMS: NET 30
SHIP VIA: Will Call
RELEASE#:
B S
I CARMEL WASTEWATER H CARMEL WASTEWATER
� 9609 HAZEL DALE PKWY P 9609 HAZEL DELL PKWY.
INDIANAPOLIS IN 46280 INDIANAPOLIS IN 46280
T T
O O
INVOICE AMOUNT: 70.83
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
"+ITEM____ ��Q,o�� QTY DESCRIPTION .°F UOMUNIT AMOUNT
,oin....,._ .__. _N __ DOIv`
-
** Location: D **
REPEQ 1 0 REPAIR-EQUIPMENT EACH 70.83 70.83
***TAG 47524***
***VICTOR OXYGEN REG.i**
****CALL JEFF 571-2634 EXT. 1637 ***
Subtotal 70.83
Visit us at facebook or oa the
web at www.indianaoxygen. om
1
Taxable amount:1 10.00
CARMEL WASTEWATER CUSTOMER: 16052 ° ° 70.83
9609 HAZEL DALE PKWY INVOICE: 01316730
INDIANAPOLIS IN 46280 INVOICEDATE: 08/03/15
ORDER: 02168499-00 P/O:
INDIANA OXYGEN COMPANY o P.O. BOX 78588 a INDIANAPOLIS, IN a 46278-0588
ORIGINAL INVOICE
IN FAANIA INDIANA OXYGEN COMPANY CUSTOMER: 16052 PAGE: 1
' P.O.BOX 78588 INVOICE: 01316951 ORDER: 02177751-00
INDIANAPOLIS, IN 46278-0588 INV DATE: 08/03/15 ORD DATE: 07/31/15
317-290-0003 SALESPERSON: 000 TERR: 005
BRANCH: 004 INT: DAB
P/O: 515343
TERMS: NET 30 j
SHIP VIA: Will Call
RELEASE#:
B S
I CARMEL WASTEWATER H CARMEL WASTEWATER
L9609 HAZEL DALE PKWY F 9609 HAZEL DELL PKWY.
INDIANAPOLIS IN 46280 INDIANAPOLIS IN 46280
T T
O O
INVOICE AMOUNT: 30.45
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
ITEM.- �sQoQnr _ DESCRIPT_IJN_-- _- _._—UONA UNIT . AMQ NTS-1--
** Location: D **
CR030018XI 1 0 300 1/8 X 1# PKG F.C. ALUMINUM LB 30.45 30.45
RE300/EO-BP 3001/8X1
Subto al 30.45
I
Visit us at facebook or oi the
web at www.indi naox gen. om
( Taxable amount: 0.00
CARMEL WASTEWATER CUSTOMER: 16052 Amo30.45
INVOICETHIS
9609 HAZEL DALE PKWY INVOICE: 01316951 INCLUDING TAX'
INDIANAPOLIS IN 46280 INVOICEDATE: 08/03/15
ORDER: 02177751-00 P/O: 515343
INDIANA OXYGEN COMPANY a P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588
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 8/18/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/18/2015 01316730 $70.83
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 Officer
VOUCHER # 156096 WARRANT # ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Wastewater Utility ;
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
01316730 01-7362-06 $70.83 I
013) 051 o i -'7ao,9-oc,
I
r'
f ppa�yy
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
r