303225 09/22/16 1+ul..44N�f
CITY OF CARMEL, INDIANA VENDOR: 154252
jg ? ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $********13.92*
CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 303225
INDIANAPOLIS IN 46278 CHECK DATE: 09/22/16
t ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350000 08406072 13.92 EQUIPMENT REPAIRS & M
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 13.92
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1094 8406072 4350000 $ 13.92 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
September 14, 2016
Signature
$ 13.92 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
8/31/16 8406072 Oxygen Tank Rental xx3325 $ 13.92
Total $ 13.92
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__:, ;": ENDING', LEASED. :CYLINDEREXTENDED
TYPE --INVOICE---- SHIPPED.:RETURNE_ BALANCE, cvuNDEas.-;BAUDAYS LIND XTENDE'
.. .. .. ..... .. BALANCE. .. .. RATE
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .409 12 .68
R CMF ASSET MkNAGEMENF FEE 1.24 1.24
TAX: &.,,--.00
CARMEL CLAY PARKS CUSTOMER 03390
_ TOTAL oo..
ra13'9
1411 E. 116TH ST. iNuoicE5084r0'6072
CARMEL IN 46032
INVOLCE DAT;E01$/43'l/16 .:-:w-
TOTAL CYL VALU1�OrOO�CJ�P/O:
INDIANA==OXYGEN-CO.IVIPANY E0-'.-`00X---,7$5,_ 88 INDIANAPOLIS, IN 46278-0588