258826 05/26/16 a°-._g�q�
CITY OF CARMEL, INDIANA VENDOR: 154252
�i• ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $********13.47*
:9� a CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 258826
°j�1?oi+'�°'9 INDIANAPOLIS IN 46278 CHECK DATE: 05/26/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350000 8388764 13.47 EQUIPMENT REPAIRS & M
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 13.47
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 8388764 4350000 $ 13.47 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 19, 2016
Signature
$ 13.47 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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
4/30/16 8388764 Oxygen Tank Rental xx3325 $ 13.47
Total $ 13.47
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
INV
- BEGINNING , N� CoFAAYS LYEERE__ YF _ __ITEM.. ..u_ _INVOICE_DATE_ __INVOICE SHIPPED RETURNED BAUDABALANCE- -
_BtiaNE --_rvus R _ AMOUNT
R CMF ASSET MkNAGEMENF FEE 0 0 0 0 0 0 1.20 1.20
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 30 .409 12.27
D E
MAY �/Y 6 .2016
TAX: 00
CARMEL CLAY PARKS cusTOMER:
1411 E. 116TH ST. IrvuoicE: 083�8'8T64` w` T1QT�►L
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CARMEL IN 46032 I 01 A,' 0'7 6i24C}l
IND 1.� A Xx`G�N-COIVIPANY P.O.BOX 78588 INDIANAPOI;IS,IN'��`46278=05$$