304638 10/31/16 'tiy u�_4;pMF
CITY OF CARMEL, INDIANA VENDOR: 154252
t'• ONE CIVIC SQUARE INDIANA OXYGEN CO
CHECK AMOUNT: $*******391.60*
: � CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 304638
.y,��oN�� INDIANAPOLIS IN 46278 CHECK DATE: 10/31/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 01501839 51.54 OTHER EXPENSES
601 5023990 01502342 115.53 OTHER EXPENSES
601 5023990 07020291 99.70 OTHER EXPENSES
2201 4231100 08410699 111.36 BOTTLED GAS
651 5023990 08411643 13.47 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
INDIANA OXYGEN CO
PO BOX 78588 - IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46278rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$111.36 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
08410699 42-311.00 $111.36 1 hereby certify that the attached invoice(s),or 9/30/16 08410699 $111.36
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, October 11,2016
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
BEGINNING 'SHIPPED: RETURNED BAUDAYS
`.INVOICE 'f ENDING LEASED
BALAN -.RATE. AMOUNT'........i.
INVOICE DATE — 1,BALANOE cE•- CYLINDERS,.
ALY ACETYLE E 3 0 0 3 0 90 .449 40.4'1
ARG ARGON 1 0 0 1 1 0 .409 .00
CO2 CARBON IOXIDE 1 0 0 1 0 30 .409 12.27
MIX MIX GAS S 2 0 0 2 0 60 .409 24.54
R OXY OXYGEN 2 0 0 2 0 60 .409 24.54
CMF ASSET Ma.NAGEMENr FEE 9.60 9.60
TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL �., 111.36
3400 W 131ST ST INVOICE: 08410699
CARMEL IN 46074 INVOICE DATE: 09/30/16
TOTAL CYL VALUE: 2700.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS,IN 46278-0588
VOUCHER # 163056 WARRANT# ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
01501839 01-6200-04 51.54.
b�SC,�.3�z (�Z�•c� tl 5.53.
Voucher Total 1(97, 0-7
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 10/17/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/17/201( 01501839 51.54
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
--------------------
_ - -
CITY aTv: DESCRIPTION UOM: AMOUNT
Y" UNiI
ITEM SHIP'D s/o_ PRICE ;
** Location: **
OX 20 1 01 1 UN1072,OXYGEN,COMPRESSED,2.2 CYL 15.922 15.92
20CF CYLINDER
20CF @ 79.6100/100CF
AL MC 1 0 1 1 ACETYLENE 10CF CYL 27.212 27.21
CGA-200
10CF @ 272.1200/100CF
FSCFUEL SRCHGWC 1 0 DIESEL SURCHARGE W/C EA 2.46 2.46
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 51.54
0TAL YLIN ERS SHIPPED: 2 RETURNED: 2
Visit us at fac book or oi the
web at wwj .indi naox gen. om
Taxable amount: 0.00
CARMEL WATER CUSTOMER: 12598 AMOUNT 51.54
INVOICETHIS
3450 W 131ST ST INVOICE: 01501839 INCLUDING
CARMEL IN 46074-8267 INVOICEDATE: 10/11/16
ORDER: 02378640-00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
------------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
ITEM QTY QTY DESCRIPTION UOM UNIT AMOUNT .'''..
_. 7SFIIP'o 7-B/0-- - PRICE
**.Location: **
OX 150 1 0 1 1 OXYGEN, COMPRESSED, 2.2 CYL 22.557 22.56
UN1072
155CF @ 14.5529/1000F
AL S 1 0 1 1 ACETYLENE, DISSOLVED, 2.1 CYL 84.556 84.56
UN1001
147CF @ 57.5211/1000F
RECORD "ACTUAL" CUBIC FOOTAGE
CF
CF
(60-175CF/CYL)
FSCFUEL SRCHGWC 1 0 DIESEL SURCHARGE W/C EA 2.46 2.46
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 115.53
TOTAL YLIN ERS SHIPPED: 2 RETURNED: 2
Visit us on fac book or oi the
web at ww .indi naox gen. om
Taxable amount: 0.00
CARMEL WATER CUSTOMER: 12598 AMOUNT• 115.53
3450 W 131ST ST INVOICE: 01502342 INCLUDINGTHIS ICE
CARMEL IN 46074-8267 INVOICEDATE: 10/12/16
ORDER: 02378790-00 PIO:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
INDIANA INDIANA OXYGEN COMPANY, INC.
O�G P.O. BOX 78588
DELIVERY TICKET
INDIANAPOLIS, INDIANA 46278-0588
Bloomington Cincinnati Elkhart v Fishers. Indianapolis
(812)330-9210 (513)353-2448. (574)295-4433 (317)84170002 (317)290-0003 '
Lafayette Marion 'Muncie + Seymour Vincennes
(765)474-7095 (765)662-8700 (765)289-237,..3 (812)522-4421 (812)882-4323
America's Oldest Gas/WeldingPP Su Z 2r1 -
. Y
10,593
CUSTOMER!
CAR't�1C.RL.: 'WfIT•E fZ L i
ORDER" i t t"
..'lti 50 }4. 131ST ST'R_.G 1 . . J.0 Y. 1 1 G
ORDER DATE'
C'APME:L. IN 4603; PAGE 0o 1 of 001
317-733-2855
DAME CARNE1 WATER TERR 007 SHIPVIA . .. .WI'll Call -NOW— INITIALS DAD
t0.# ' ' ,SALES OI"o SHIP CODE 01) 'UPS. 0 ORDER TYPE ; CWRG
ZEL# BRANCH 004 :COL/PPD PREPAID TIME #1-CCT-15 02t109M'
'HONE# 317-733-2855• SEL ROUTE# USERNAMEderriekb
0 Y, UNIT Ht�.----__--DESGRIPTIC�J- ----�_=--- ID � L NE .'-------ITEt'i-=---- LOC QTY CYLINDERS= VOLUME/ UNIT EXTENDED
SHIP & HAZARD CLASS N NDLR. EIC ., NUMA,ER ORDER 13"r1IP RETN WEIGHT AMOUNT MOUNT
1 CYL- UN1072,OXYGENgCWRESSED,2.2 I OX 20 D i 1 1 20 .
,15.922. 15.92
20CF CYLINDER
13.00
I CYL ACI YLEiNE,DI OLVED,2111 '12, AL IAC D` 1 1 . 1 10 ?7.212 : 27.21
LN1001
(ACETYLENE 10CF)
(CCA-200)
------------------------------------
CITY UNIT Hai - ----- LINE -----ITER------- LOC CTY CITY DIN WEIGHT. UNIT EXTENDED
SHIP b HAZARD CLAM 0 Nl1t'iDER. ORDER MORD LOC P14OLW Ahab T
1 EP DIESEL SURCHARGE WICFwC FUEL SI CN 'C D 1 0 .00 MG 2.46
I EA HAZARDOUS tIATERIAL CHARGE 4 HIPC' HAZ MAT CHS D 1 0' .00` 5.95 5.95
Teel Weight:: 21.0000 Subtotal 51,54
Tau .00
_{/ /�( Freight 00
((
R tt 0{ •�0�S
Date : Total Sale 51,54
IP"o #
vkl
0urc11
PE HIND L' i's" l LEPHft NUMBER. 800 55056 PLACARDS: � ACCEPTED � REFUSED
Cu5to®er authorises Seller to debit Customer's credi Gard or deduct frai the TERMS&CONDITION
S
Custamer's deposit an outstanding balance remaining on the Custoaer's account THE CUSTOMER HEREIN CONSENTS TO AND ACCEPTS THEA PRODUCTS,
P Y A SUBJECT TO ALL OF THE CONDITIONS AS SET FORTH ON REV SE$IDE EEO
/ AND THE EXISTING CONTRACT BETWEEN BOTH PA. IE
IMPORTANT X "� r 7 0 s1 r
'LEASE READ CAREFULLY THE TERMS AND CONDITIONS OF SALE WHICH APPEAR �1 , ECVaED SIG DATE
V THE REVERSE SIDE OF THIS DOCUMENT.ALL SALES MADE ARE SUBJECT TO C
UCH TERMS AND CONDITIONS. CUSTOMER SIGNATURE HEREON `VERIFIES X
HIPPED AND RETURNED RENTAL CYLINDER COUNT. SHIPPED BY
ni icTr%Rel=o
TITLI' T'O ALI- MWEREET fit MS INVCMCE FRI-73MAIDNIS THE
FROMIR,TY OF DX'3'GE',',1(70� Ff\1C. U. I'AdD FOR IN FULL.
IT B ARE R-ENTF.DTO (7L'1-S",r'OMF'R
AND NOT11 LE PASSE',:-, TO, ER, Cuks,�,c..fnct7 agr.,cs to p�ly a
(kpok of S i WO sw wwh "nay this depcnit wivi cash
-i a is edit c.,ard. Thc dv:qjc,;J,
J t wili bc rerurned to Culonwr Whin 45days A er Customer
renu-m is ali Cylinders in Cummer's Imsession. Gmoniu.i' aclhnowk-,dges that th,-, dt'posit'
cw any porthn Meof may bc widiheld for damag,,-, uripaid rent, �usl, cyfindcrs- an- Cjr
any am wndhg W nee rcanti rJ on Qwt-,.',rne r's wCourA,
charge, at evabikhed raw, Oil 7e i-"-"VJmd Cm We Ws',d,-A,.), ufeacb caic-nda, n
Customer agrems to be responsibie 1"bi joss or Comage to amyvYlindlc'i rcsWng hum
EMY Cmae We i-r
aul:nmlvi.-.d�;es law`!ivt -y und
faccqfanu.c of-jm, `or) go%-,,di cwfdoa and alyces to remm said Quders W gooid
eondition. Nlo change in or adldun R1 A, .zvn-<F' ar....J provisions be ruade.
Wess approved Q wAng by a rqTewhahve of War andwrhed to sceept Hil
ffic ut
,' i tea,. FICONg 'if rmcd cylinders ...i.L1 by dho ov loan ol.'cylinmers wit
the &Jler's vv-ritfz:"n conscju-' prohi-tited. Af! empty cy1Piad.e,-,,s �-had be retu..'..no(i to !he
Jett Mi capy Said cyAdws reaumod Whoul �-'Pqx- s4alHbc� 10 1.j:`
S ,.2.r con
$8,00 PCr
C Lj ST OTVIE-RS E'TA ENHIIN,G-CNj"M DER 0 V 6 'MAT f F!S Nffk'%��' 13F B"A 1-L-LED R.)R
EVE A -'Y N Y I S I- t. iJ,Ik E-11) T-0
S A NM E� -EN' T 1-3 17,, E 1, J A:N -T C(';'�,APA;
U-SOF,'T -F(D AAMON, AL,,Y DUE FkDSA--�;-'
-11-VTWE EVENTICK !S TO RESORT TrO 1-Ecpt_L
ACTION'ro ANT-L-ECT A.1,4Y A,-NAMNTS DUE. FROM THIE'. C,13SIVC)I'AF,"s; TiT SHAM
BE ENT11MLE.D 'TO RJECO'VER!, _Q%' A'CONNL)IN, TO THE AMOUNTS DUE, M,
C'MURT COS'I'S AND REPACMA311 ATTORYZ,,� � EES AND/OR AGEN'T TFEF,.S.
Customer tLar Cummel Will b; Mfgwd at iiai-rjirro_fa a $25.f,11i) by
Indiana Oxyg.e.n Co. for ar"y thwt "is to
aray be !"'wr wi-G-jou", ftom us in v,,Jtint
Said, k-aerclh a�i dis c i s S alt7ic'."'t t 6 i, j-0s 1n,_, ChmgO t:' ti3C up 0 bn 03 do Se U a, Pitts
iranspojl.alon iTpickc.,1 Up by the stll;r.
Warmly: Wana Oxygmn C,,-), wc;!rants tinw le Cis Muds Swerud hwund
!a.'9y 1 '4 war
be ofstzndard p,�uri9.y, as 6ci'mmi Q; A; Comuresse'd 6"'a"s
Oxygen rni�vcs "I(j myranty of
but jwt Hit hod to, annywar,-an�.,'.'Ydna'0 po
D HAMAMOM d;,1"1& S A A b i b ty f th U A S az.''{' UC i f b"i Sh Cd 1-1 C-d f)d OT'�Or th'j U-S,-
Cantel-rip"'atedi by Cus"k"irier is Sole
Connecom merdwito, a
TERAW JAEF 30 DAYS, 1 :IT PEA ii,,AON"'T'H /vIN HER
ANNUM CHARGE (314 WAPAID 3. A-TATN�,.,,03 'AIM. BE ADDED. -
`yV
INDIANA -�. �, s �` �. INDIANA OXYGEN COMIPANY,''.INC.
®ICYYC P.O. BOX 78588 DELIVERY TICKET
INDIANAPOLIS, INDIANA-46278-0588
Bloomington Cincinnati Elkhart Fishers Indianapolis
(812)330-9216 (513)353-2448 (574)295-4433 1(317)841-0002 (317)290-0003
Lafayette Marion Muncie? +. Seymour + Vincennes
(765)474-7095 (765)662-8700 (765)289-2373 (812)522-4421 (812)882-4323
America's Oldest Gas/Welding Supply �f, �j ;'79 2 5`56
CUSTOMER p
ORD=R A —7
i(,: W ..s:(c} I' us;..I"�:ba�c.T ORDER DATE
PAGE 9. 0-F
NAME ��; ,.�� tl,-t� TERR 007 SHIP VIA LIH Call ���y��_ INITIALS ITF5
P.O.# SALES 000 SHIP CODE ql�j UPS 0 ORDER TYPE 11F.M.3
REL# BRANCH f,;� COUPPD �'i�`.c'AID TIME 1},_i;,^i-16 493®4-Yil
PHONE# 41 - ROUTE# USERNAME 8]d `
19TY 11 71'" Hill __.._ _f" �,tt3F'1)C:;-----««____- 9 y �1J' _ «_«t �.< I! _ tF 1n. w � c I I.,,r UNIT ,;E
�!:_i Hill w I�.L ..,, L a:� _ld.sa-«..___ �� )T'r C.i....;�',fc - �;,:,_I_`pl �..i �rkT�"ia,L"
C r1 i_P, •#' I ��i1 h' ' nr t7 (
%�a��!-^cl7 Sl-iI� � Tt�3 s,�.at" tw-v:�n�� A�i;rIJ��,)T {
'.� .!!k;
a. CYL [SXym, CCI:"`ugsu14 c,r? ) 'H 15+.9 A t 1 i 9.55 22.33 2''~'.5h
Utl1.07'
'.t_ A�:.`i L`_tlmy QIKt:_t-:.7g S..1 2 k•c.. 5 A 1 147 e34.1 Z S r...,_,
f+s
61C F091HAE-E
C.
t 60-r 7cKF I CYL.)
2-b.00
clEnA ' _rjv iIt QIr B:�1 lC-! U1111 E`t,i[+'<Jr,�
is s a t T `t�)1n y�- r r. _�
31 KPLORD LLAT F TIC 4.��L'�€� GR�DER. EK133D LCA.
--------------
fr^.1 E1 Dil—�'-� :4i,,_, 1 0 10 :. f: Yza
EA F,iZ;i7ll IfE 'si4111'[WL CHAIRRi, _-_ h.°G MIZ 1-V)7 111=i _.
u3yL2fiuv°.�.� ltf'1.01[jLaif ."..... .............._._..__..- 0«,_ .. .. _v6S��U�:c1�1 115,53
Tu-'6a Cain! 10153
53
3PECIAL INSTRUCTIONS: PLACARDS: ACCEPTED REFUSED
EttKKE�" riESI'0a 42E T ELEP'HMIE Pel'iE 8005-355{353
TERMS&CONDITIONS
EIst-lager ch1!izes Seller, to debit Castoner's credit ea5d v dedurct f' �
the THE CUSTOMER HEREIN,GONSENTS TO AND ACCEPTS THE ABOVE PRODUCTS
SUBJECT TO ALL OF:r CONL}ITIONS AS SET FORTH ON REVERSE SIDE HEREOF
Ctistaaoerl s deposit any wAstandang balance Nendni-ng on the CvStoneral s q![011Fjt ANVHE XIS11 G CONTRACT BETWEEN BOTH PARTIES.
IMPORTANTX / iX
PLEASE READ CAREFULLY THE TERMS AND CONDITIONS OF SALE WHICH APPEAR ,///RLCEIVED BY(SIGNATURE) DATE
ON THE REVERSE SIDE OF THIS DOCUMENT.ALL SALES MADE ARE SUBJECT TO
SUCH TERMS AND CONDITIONS. CUSTOMER SIGNATURE HEREON VERIFIES X
SHIPPED AND RETURNED RENTAL CYLINDER COUNT. SHIPPED BY
CUSTOMER
P . REIVIAINS THE
FON 1N FULL.
!T is AW VO CiJSIVIOMER
�I r , r
KID L i
J: __ 1_a.4 d1t. .- ' �' ..,.i,.... i :_ _... .. L'.4i '�,�!".I s. it ={•J s.1.;itOti �.liCi t.zi.Pl�r�i�Ii'•,�i
i1'.it Cid tiF; d3s1 t.
i. t
_-Co1i14L1.Si C, i .si, 19, and/or
vi /;
a. tial ii_, '/ 1"E;ttl.ill v7 °
_ t _7 fit .Ii1r :l.g
" izldr,3' .OS-L -ing f1'om
4 :0 t OlOnYWO&Q. lovely and
'CS'v i. P's m,-,-de
symed to the
t ili�lt, HS .Ir. .'1! t4L [ i1-SjI,ED FOR
E I...� �0
QM10,, ;. 0'
r,
r�; TT SHALL
P. S.
by
rey ;1,� L<t ot).y1}�..Gq{1Y ;S�r�Cll
t.
.�.•J.J:I, ��.,fJ1 1.11'.1,i'1 v... .314ALu.rla
L,,._ s,.:4, t << e'. ..r' " :!._.. lis P a .f1= _ i}a C c L'f.a' '➢19m,o's'0.
VOUCHER # 162960 WARRANT# ALLOWED
154252 IN SUM OF $
INDIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV# ACCT# AMOUNT Audit Trail Code
07020291 01-6360-03 99.70
Voucher Total 99.70
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 10/6/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/6/2016 07020291 99.70
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
Date Officer
-INV SUP .. RNT PERIOD,.::.EXPIRATION.,'. .: :. .. '. CYLRATE':, . .
TYPE GROUP... DATE DESCRIPTION .. LEASED<;_ AMO NT..
L ACI MIX 12 10/2016 '07020291 1 99.70 99.70
J
W 7
jE0rFER,1YEAR D 5 YEAR LEASES
YR $12.19 PE CYL (ACETYLENE=$209.16) PLUS TAJ
CARMEL WATER CUSTOMER: 1259899.70
TOTAL
3450 W 131ST ST INVOICE: 07020291
CARMEL IN 46074-8267 INVOICE DATE: 10/03/16
P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588
VOUCHER # 166338 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
08411643 01-7362-06 13.47
Voucher Total 13.47
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 10/7/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/7/2016 08411643 13.47
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
Date Officer
CYLINDER RENTAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER:20668 PAGE: 1
P.O.BOX 78588 INVOICE: 08411643
INDIANAPOLIS,IN 46278-0588 INV DATE: 09/30/16
317-290-0003 SALESPERSON:0 0 0 1 TERR: 007.
BRANCH: 004
P/O:
TERMS: NET 3 0
B CARMEL CITY OF H CARMEL CITY OF
�
9609 HAZELDELL ROAD P 9609 HAZELDELL ROAD
INDPLS IN 46280 INDPLS IN 46280
T T
O O
INVOICE AMOUNT: 13 .47
---------------------------------------- PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
IN" -' ITEM INVOICE DATE INVOICE''"S BEGINNING SHIPPED RETURNED ENDING' : LEAseo BAL/DAYS r iCYLINDER 9 EXTENDED.
P
_.. __. .... BALANCE .. .. BALANCE_. .CYLINDERS .•:,.RATE AMOUNT .:
ARG ARGON 1 0 0 1 0 30 .409 12.27
CMF ASSET MANAGEMENr FEE 1.20 1.20
TAX: .00
CARMEL CITY OF CUSTOMER: 20668TOTAL 13.47
9.609 HAZELDELL ROAD INVOICE: 08411643
INDPLS IN 46280 INVOICEDATE: 09/30/16
TOTAL CYL VALUE: 300.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588