HomeMy WebLinkAbout252324 1 2/08/1 5 y '��?yf
.,� CITY OF CARMEL, INDIANA VENDOR: 154252
® _ ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: S"``+""39.38`
,. +� CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 252324
+.y_TON,�, INDIANAPOLIS IN 46278 CHECK DATE: 12/08/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 01363665 39.38 OTHER EXPENSES
ORIGINAL INVOICE
INDIAN I-A INDIANA OXYGEN COMPANY CUSTOMER: 12598 (PAGE: 1
P.O.BOX 78588 INVOICE: 01363665 ORDER: 02230768-00
INDIANAPOLIS,IN 46278-0588 INV DATE: 11/23/15 I ORD DATE: 11/23/15
317-290-0003 SALESPERSON: 000 TERR: 007
BRANCH: 001 T INT: TIM
P/O:
TERMS: NET 30
SHIP VIA: Will Call
RELEASE N:
B S
I CARMEL WATER H CARMEL WATER
� 3450 W 131ST ST F 3450 W 131ST STREET
CARMEL IN 46074-8267 CARMEL IN 46032
T T
0 0
INVOICE AMOUNT: 39-38
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
_ITEM °�� - -�n. _ �_ _ _ DESCRIPTION. - UOM NIT AMOUNT
** Location: A **
I '
CD 5ORB 1 0 1 1 CARBON DIOXIDE, 2.2 CYL 30.62 30.62
UN1013 (LIQUID WITHDRAW)
50CF @ 61.2400/100CF
FSCFUEL SRCHGWC 1 0 DIESEL SURCHARGE W/C EA 2.81 2.81
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 39.38
TOTAL CYLINDERS SHIPPED: 1 RETURNED: 1
Visit us on facebook or oa the
we at www. indianaox gen. om
Taxable amount:1 10.00
CARMEL WATER CUSTOMER: 12598 • 39.38
THIS
3450 W 131ST ST INVOICE: 01363665INCLINVOICE
DINGTAX
CARMEL IN 46074-8267 INVOICEDATE: 11/23/15
ORDER: 02230768-00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588 9 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 12/1/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/1/2015 01363665 $39.38
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 # 153711 WARRANT# ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
01363665 01-6200-06 $39.38
Voucher Total $39.38
Cost distribution ledger classification if
claim paid under vehicle highway fund
i