HomeMy WebLinkAbout304284 10/20/16 �..c,q+, CITY OF CARMEL, INDIANA VENDOR: 154252
`/ CHECK AMOUNT: $*******172.31
.,. ONE CIVIC SQUARE INDIANA OXYGEN CO
s. ? CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 304284
9��(lONI�• INDIANAPOLIS IN 46278 CHECK DATE: 10/20/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239012 01497272 158.84 SAFETY SUPPLIES
1094 4350000 08410409 13.47 EQUIPMENT REPAIRS & M
Voucher No. Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278-0588
In Sum of$
$ 172.31
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE N0. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 1497272 4239012 $ 158.84 1 hereby certify that the attached invoice(s), or
1094 8410409 4350000 $ 13.47 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
October 12, 2016
Signature
$ 172.31 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
9/30/16 1497272 Oxygen Tank Refills xx4394 $ 158.84
9/30/16 8410409 Oxygen Tank Rental xx3325 $ 13.47
Total $ 172.31
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
------------------------------------------- rLt:AW:0trvU [Ur rUKI1UNVVI IrnYUUrcrNYMtNI--------------------------------------------
ITEM'; QTY QTY DESCRIPTION U0M UNIT AMOUNT.
_. _ ... .._
PRICE.
SHIED B/O.
.,
** Location: A, **
OX AD 4 0 4 4 OXYGEN, COMPRESSED 2.2 CYL 30.236 120.94
UN1072 (USP GRADE)
60CF Q 201.5733/1000F
ENTER LOT NUMBER ABOVE
Lot: S0921601 Q y: 2 Lot: 50922601 Qty: 2
FSCFUEL SURCHRG 1 0 DIESEL SURCHARGE OUR TRUCK EA 2.97 2.97
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subto al 129.86
OTAL YLIN ERS SHIPPED: 4 RETURNED: 4
Visit us on fac book or on the Delivery Cha ge 28.98
web at .indi naox gen. om
Taxable amount:1 10.00
CARMEL CLAY PARKS CUSTOMER: 03390 • • l58.84
1411 E. 116TH ST. IWEFQ
97272 ,
10
CARMEL IN 46032 INVOIC �30;"/16 '"'
ORDER: 02372792-00 P/O:
IINIDI�A�N�AOXYGEN�COIVIP�ANY'. POB�X�:785.8$'����IND�t'y APO�;I�S;r�IN �1�46278 058,8�r
INV
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
I
ITEM INVOICE DATE" INVOICE BEGINNING SHIPPED RETURNED ENDING.•. 'CEASED:' . ;:CYLINDER EXTENDED:...:'
P :.•> A .:BALANCE.; ....-.. BALANCE .CYLINDERS ..RATE. ..AMOUNT.=
SHP SMALL HIGH PRES URE 1 4 4 1 0 30 .40-9 -12--27-
CMF ASSET MANAGEMENr FEE 1.20 1.20
TAX: .00
CARMEL CLAY PARKS CUSTOMER-0-3,39.0 13.47
1411 E. 116TH ST. INYOIGE�AJ. 0409
.„_
CARMEL IN 46032 aINYOICEDATE: 09/30/16
TOTAL CYL VALUE: 100.00 P/O:
INDIANA OXYGEN-CO'NIP�iN, '_ P O_BOX 78588 _INDIANAP.OLIS,IN 462,7-8 0.588