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HomeMy WebLinkAbout260076 06/28/16 tij.coq y� .• CITY OF CARMEL, INDIANA VENDOR: 36002 J ONE CIVIC SQUARE 982• AXAIR DISTRIBUTION INC CHECK AMOUNT: $*******108.88* CARMEL, INDIANA 46032 DEPT CHPR10660 CHECK NUMBER: 260076 9M«oN. PALATINE IL 60055-0660 CHECK DATE: 06/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231100 73394229 108.88 BOTTLED GAS I VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) 982-PRAXAIR DISTRIBUTION INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER DEPT CH 10660 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service PALATINE, IL 60055-0660 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $108.88 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 73394229 42-311.00 $108.88 1 hereby certify that the attached invoice(s),or 6/21/16 73394229 $108.88 1120 101 1120 101 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 Tuesday,June 21,2016 David Haboush Fire Chief 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer QUESTIONS: COMMENTS: F�LEIREFEi INQUIiES REGARDINGIia' INVOICE p.� Please note the format of your invoice has changed and now includes more '' in ormation to help you manage your Praxair account. PRAXAIR DISTRIBUTION,INC. CUSTOMER SERVICE 1400 POLCO ST If ou wish to receive the document electronically in the future,please contact us. INDIANAPOLIS IN 46222 800-266-4369 Pay your bill by credit card! Call 1-800-266-4369 to start. i INVOICE DETAIL AND PURCHASE DESCRIPTION TERMS: Net 10 Days 'AY�MENT DUE 61207 ITEM NUMBER ITEM DESCRIPTION CITY CITY BACK UOM VOIJWT UNIT AMOUNT TAX SHIP RETN ORDER PRICE Y/N INVOICE NO:73394229 CUSTOMER:71675029 DATE:6/4/2016 SHIP FROM 70613,PXPKG INDIANAPOLIS IN HS ORDER REFERENCE 79990996 DT 6/3/2016 PT#71175242 CUSTOMER PO/RELEASE VERBAL-TOM SHIP VIA Our Truck SHIP TO ACCOUNT:76168978 OX M-M OXYGEN USP M 2 3 CO 29.74 59.48 N UMSCFCD2 ENERGY AND FUEL CHARGE USSURF IEE 1 EA 12.50 12.50 N U777HMD3 HAZARDOUS MATERIAL CHARGE USS�URFEE 1 EA 11.90 11.90 N UDELIVERYCHARGE DELIVERY CHARGE USSURFEE 1 EA 25.00 25.00 N Total Cylinders Shipped/Returned 2 3 ACCOUNTS PAST DUE WLL BE CHARGED PLEASE NOTE PAYMENT OF THIS INVOICE ACKNOWLEDGES THAT SUBTOTAL TAX AM OUNT IN1/OICE AAOl�1NT¢. A SERVICE CHARGE OF$1 OR A FINANCE THE ABOVE SHIPMENTS,RETURNS,ANDIOR BALANCE OF THE CHARGE OF 1.5%PER MONTH(18% PRAXAR CYLINDERS IN YOUR POSSESSION IS CORRECT AT THE ANNUAL RATE)OF THE OUTSTANDING CLOSE OF BUSINESS ON THE DATE SHOWN ON THIS iNVOICE. @ BALANCE,WHICHEVER IS GREATER OR 0.00 0.00 US�+ $D - 108.88 CONTRACTUALLY ALLOWED. 343-011