259789 06/16/16 (2) s/ CITY OF CARMEL, INDIANA VENDOR: 154252
b „ ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $********27.84*
z ,?� CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 259789
INDIANAPOLIS IN 46278 CHECK DATE: 06/16/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350000 08384413 13.92 EQUIPMENT REPAIRS & M
1094 4350000 08393082 13.92 EQUIPMENT REPAIRS & M
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 27.84
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#'
1094 8384413 4350000 $ 13.92 1 hereby certify that the attached invoice(s), or
1094 8393082 4350000 $ 13.92 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
June 8, 2016
Signature
$ 27.84 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
- INV---> - off-.�-r BEGINNING - ENDING LEA5ED CYLINDEH - EXTENDED
P ITEM"' " INVOICE DATE- INVOICE BALANCE SHIPPED RETURNED BALANCE CYLINDERS BALroAYS RATE AMOUNT
CMF ASSET NANAGEMENT FEE 0 0 0 0 0 0 1.24 1.24
SAL SMALL ACETYLENE 0 1 1 0 0 0 .409 .00
SHP SMALL HIGH PRESSURE 1 1 1 1 0 31 .409 12.68
dui "° 2016
TAX: .00
CARMEL CLAY PARKS CUSTOMER: _03390 TOTAL
1411 E. 116TH ST. IhoGE Or8�384°413 r
CARMEL IN 46032 INVOICED TE:
TOTAL CYL VALUE: 100.00 P/O:
INDICIA O�X�YGEN-�CO�VII'ANY-•--PO:�BOX 78'S88�"INDIANAPOLIS;�IN-.:.•�46278��Q588
INV. '__:.ITEM INVOICE nATE-�.:i.INVOICE,.; ..BEGINNING. SHIPP_ED,. RETURNED trvu�rvu �_��_� BALJDAYS '
__. - .. .. 3A'v.iJCE--.. _ BALANCE, :CYLINDERS- .. _� __ ._RATE-.. .,�'AMOUNT
FYP - __.
R SHP SMALL HIGH PRESSURE 1 0 0 .1 0 31 .409 12.68
R CMF ASSET MkNAGEMENr FEE 1.2.4 1.24
TAX: 00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL ® 13 .92
1411 E. 116TH ST. 1NVOME: 08393082
CARMEL IN 46032 INV016EDATE: 05/31/16
TOTAL CYL VALUE: 10 0.0 O' P/O:
�._ tkyi,ki - .! 6:'n ?�,.:: - _j fi t. },k y ni•'F,3' y '
I1�pD�I�1�1� OX�Y�G,E'N CUMaP T=Y• P.O.B'OX 78588•�IN IaA�IAPOLIS,YIa1 T. ._ 4b2�7c8�0588