302173 08/22/16 %' Eqpt•_ CITY OF CARMEL, INDIANA VENDOR: 154252
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $*******364.84*
CARMEL, INDIANA 46032 PO
ND ANAP05 S81N 46278 CHECK NUMBER: 302173
,roN CHECK DATE: 08/22/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 01474375 235.84 BOTTLED GAS
2201 4231100 08402042 115.08 BOTTLED GAS
651 5023990 08402995 13.92 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
INDIANA OXYGEN CO ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Po Box 78588 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46278 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$115.08 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department 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
08402042 42-311.00 $115.08 1 hereby certify that the attached invoice(s),or 7/31/16 08402042 $115.08
2201 201 2201 201
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesday,August 09,2016
Dave Huffman
Director
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
, 20-
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
NV - _ __-_ITEM- --INVOICE-DATE - INVOICE BEGINNING_. SHIPPED RETURNED -- ENDING_ LEASED_ _BAUDAYS.. _CYLINDER.- ....- EAMOUN D. _
TYPE BALANCE BALANCE CYLINDERS RATE AMOUNT
R ALY ACETYLENE 3 0 0 3 0 93• .449 41.76
R ARG ARGON 1 0 0 1 1 0 .409 .00
R CO2 CARBON DIOXIDE 1 0 0 1 0 31 .409 12 .68
R MIX MIX GASES 2 0 0 2 0 62 .409 25.36
R OXY OXYGEN 2 0 0 2 0 62 .409 25.36
R CMF ASSET MANAGEMENF FEE 9.92 9.92
TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851TOTAL , 115.08
3400 W 131ST ST INVOICE: 08402042
CARMEL IN 46074 INVOICE DATE: 07/31/16
TOTAL CYL VALUE: 2700.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
INDIANA OXYGEN CO ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PO BOX 78588 IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46278 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$235.84 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Street Department 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
01474375 42-311.00 $235.84 I hereby certify that the attached invoice(s),or 8/8/16 01474375 $235.84
2201 201 2201 201
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,August 15,2016
Dave Huffman
Director
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
ITEM- sHi o.. .--Bro: - DESCRIPTION-- — UOM - RICE _ ._... AMOUNT-
** Location: **
OX 220 2 0 2 2 UN1072,OXYGEN,COMPRESSED,2.2 CYL 29.191 58.38
220CF CYLINDER
i
440CF @ 13.2686/1000F
AL S 2 0 2 2 ACETYLENE, DISSOLVED, 2.1 CYL 84.556 169.11
UN1001
i
294CF @ 57.5211/1000F
RECORD "ACTUAL" CUBIC FOOTAGE
i
CF
CF
(60-175CF/CYL)
FSCFUEL SRCHGWC 1 0 DIESEL SURCHARGE W/C EA 2.40 2.40
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 235.84
TOTAL YLI ERS SHIPPED: 4 RETURNED: 4
I
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Visit us at fac book or ol the
web at www.indianaox gen. om
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Taxable amount: 0.00
CARMEL STREET DEPT CUSTOMER: 07851 235.84
3400 W 131ST ST INVOICE: 01474375
CARMEL IN 46074 INVOICEDATE: 08/08/16
ORDER: 02349598-00 P/O: SHOP 8/8/2016
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 9 46278-0588
VOUCHER # 165891 WARRANT# ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
08402995 01-7362-06 13.92
Voucher Total 13.92
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 8/5/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/5/2016 08402995 13.92
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
INV - _ _ITEM.:�.-._c_ .— INVOICE.DATE..... INVOICE BEGINNING ENDING .LEASED. CYLINDER EXTENDED.
—'' BALANCE-----SHIPPED.RETURNED -BALANCE —-CYLINDERS-^BAL/DA- ,_. ,_RATE- ---- -'AMOUNT---— -
R ARG ARGON 1 0 0 1 0 31 .409 12 .68
R CMF ASSET AGEMENU FEE 1.24 1.24
TAX: .00
CARMEL CITY OF CUSTOMER: 2 0 6 6 8TOTAL , 13 .9 2
9609 HAZELDELL ROAD INVOICE: 08402995
INDPLS IN 46280 UWOICEOATE: 07/31/16
TOTAL CYLVALUE: 300.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588