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Home My WebLink About300890 07/25/16 '- J` ,_..--*fCITY OF CARMEL, INDIANA VENDOR: 3602 2 ONE CIVIC SQUARE 982-PRAXAIR DISTRIBUTION INC CHECK AMOUNT: $*******253.41* CARMEL, INDIANA 46032 DEPT H iosso CHECK NUMBER: 300890 PALAT NEIL 60055-0660 CHECK DATE: 07/25/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231100 73677153 106.76 BOTTLED GAS 1120 4231100 73684071 146.65 BOTTLED GAS VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) 982-PRAXAIR DISTRIBUTION INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER DEPT CH 10660 IN SUM OF$ 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. $106.76 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 73677153 42-311.00 $106.76 1 hereby certify that the attached invoice(s),or 7/18/16 73677153 $106.76 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 an received except Monday,July 18,2016 David Haboush Fire Chief 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 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer QUESTIONS: COMMENTS: PLEASE REFER INQUIRIES REGARDINCsTHIS INVOICE TO __ lease note the format of your invoice has changed and now includes more nformation to help you manage,your Praxair account. PRAXAIR DISTRIBUTION,INC. CUSTOMER SERVICE 1400 POLCO ST f you wish to receive the document electronically in the future,please contact us. INDIANAPOLIS IN 46222 800-266-4369 ay your bill by credit card! Call 1-800-266-4369 to start. INVOICE DETAIL AND PURCHASE DESCRIPTION TERMS: Net 10 Days PAYMENT DUE7t17120�6� ITEM NUMBER ITEM DESCRIPTION QTY CITY BACK UOM VOL/Wr UNIT AMOUNT TA;1 SHIP RETN ORDER PRICE Y/N INVOICE NO:73677153 CUSTOMER:71675029 DATE:7/7/2016 SHIP FROM 70613,PXPKG INDIANAPOLIS IN HS ORDER REFERENCE 80949381 DT 7/6/2016 PT#71307918 CUSTOMER PO/RELEASE VERBAL-TOM PAYNE ORD BY PHON SHIP VIA Our Truck SHIP TO ACCOUNT:76168978 OX M-ADN OXYGEN USP AD(COC ONLY) 6 16 CO 9.62 57.72 N UMSCFCD2 ENERGY AND FUEL CHARGE USSU FEE 1 EA 12.50 12.50 N UZZZHMD3 HAZARDOUS MATERIAL CHARGE U SURFEE 1 EA 11.54 11.54 N UDELIVERYCHARGE DELIVERY CHARGE USSURFEE 1 EA 25.00 25.00 N Total Cylinders Shipped/Returned 6 16 ACCOUNTS PAST DUE WILL BE PLE NOTE PAYMENT OF THIS INVOICE ACKNqWLEDGES A SERVICE CHARGE OF$1 OR A FINANGCE ED THE ABOVE SHIPMENTS,RETURNS,AND/OR BAL INCE OF THE AT SUBTOTAL TAX AMOUNT -INVOICE,,- T, ''a CHARGE OF 1.5%PER MONTH(18% PRAXAIR CYLINDERS IN YOUR POSSESSION IS C=�Q`R.RECT AT THEANNUAL � BALANCE,WHICHEVER HEVER GOF THE REATER OR TANDING CLOSE OF BUSINESS ON THE DATE SHOWN ON INVOICE 106.76 0.00 USD $ 106.76 CONTRACTUALLY ALLOWED. __ I 343-01 F 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. $146.65 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 73684071 42-311.00 $146.65 1 hereby certify that the attached invoice(s),or 7/18/16 73684071 $146.65 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 Monday,July 18,2016 David Haboush Fire Chief 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 ,20- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer QUESTIONS: COMMENTS: SPL, E REFER INQUIRIES REGARDING THIS INVOICE TO f Please note the format of your invoice has changed and now includes more information to help you manage your Praxair account. PRAXAIR DISTRIBUTION,INC. CUSTOMER SERVICE 1400 POLCO ST If you 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. INVOICE DETAIL AND PURCHASE DESCRIPTION I TERMS: Net 10 Days PAYME OQE j71,L812Q16" ITEM NUMBER ITEM DESCRIPTION CITY CITY BACK UOM VOLWT UNIT AMOUNT TA� SHIP RETN ORDER PRICE Y/N INVOICE NO:73684071 CUSTOMER:71675029 DATE:7/8/20113 SHIP FROM 70613,PXPKG INDIANAPOLIS IN HS ORDER REFERENCE 80984499 DT 7/7/2016 PT# CUSTOMER PO/RELEASE SHIP VIA Our Truck SHIP TO ACCOUNT:76168978 OX M-ADN OXYGEN USP AD(COC ONLY) 10 CO 9.62 96.20 N UMSCFCD2 ENERGY AND FUEL CHARGE USSU FEE 1 EA 12.50 12.50 N UZZZHMD3 HAZARDOUS MATERIAL CHARGE U SURFEE 1 EA 12.95 12.95 N UDELIVERYCHARGE DELIVERY CHARGE USSURFEE 1 EA 25.00 25.00 N Total Cylinders Shippe /Returned 10 ACCOUNTS PAST DUE WLL BE CHARGED PLEASE NOTE PAYMENT OF THIS INVOICE ACKNOWLEDGES THAT SUBTOTAL TAX AMOUNT ''INVOICEAMOUNT� A SERVICE CHARGE OF$1 OR A FINANCE THE ABOVE SHIPMENTS,RETURNS,AND/OR BALA YCE OF THE CHARGE OF 1.5%PER MONTH(18% PRAXAIR CYLINDERS W YOUR POSSESSION IS COF RECT AT THE � ANNUAL RATE)OF THE OUTSTANDING CLOSE OF BUSINESS ON THE DATE SHOWN ON TH INVOICE. BALANCE,WHICHEVER IS GREATER OR 146.65 0.00 USD $ 146.65 CONTRACTUALLY ALLOWED. 343-01F