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Home My WebLink About304450 10/31/16 ,CSA. ''• CITY OF CARMEL, INDIANA VENDOR: 360202 ;, 31 ONE CIVIC SQUARE 982-PRAXAIR DISTRIBUTION INC CHECK AMOUNT: $*******41 1.38* r, " CARMEL, INDIANA 46032 DEPT CH 10660 CHECK NUMBER: 304450 9M_TON�� PALATINE IL 60055.0660 CHECK DATE: 10/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4231100 74468548 234.99 BOTTLED GAS 1120 4231100 74603131 176.39 BOTTLED GAS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) 982-PRAXAIR DISTRIBUTION INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER DEPT CH 10660 IN SUM OF$ 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. $234.99 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 74468548 42-311.00 $234.99 1 hereby certify that the attached invoice(s),or 10/11/16 74468548 $234.99 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 Thursday, October 13,2016 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 note the format of your invoice has changed and now includes more PLEFI.SE REFERit QUIRIE5 REGARDING THIS INVOICE TO o:; 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 TERMS: Net 10 Days ;PAYMENT DUEO1412 6 ITEM NUMBER ITEM DESCRIPTION CITY QTY BACK UOM VOUWT UNIT AMOUNT TA� SHIP RETN ORDER PRICE YIN INVOICE NO:74468548 CUSTOMER:71675029 DATE:9/24/2016 SHIP FROM 70613,PXPKG INDIANAPOLIS IN HS ORDER REFERENCE 83598507 DT 9/23/2016 PT# CUSTOMER PO/RELEASE SHIP VIA Our Truck SHIP TO ACCOUNT:76168978 OX M-M OXYGEN USP M 2 2 CO 29.74 59.48 N OX M-ADN OXYGEN USP AD(COC ONLY) 13 13 CO 9.62 125.06 N UMSCFCD2 ENERGY AND FUEL CHARGE USSURFEE 1 EA 12.50 12.50 N UZZZHMD3 HAZARDOUS MATERIAL CHARGE USSURFEE 1 EA 12.95 12.95 N UDELIVERYCHARGE DELIVERY CHARGE USSURFEE 1 EA 25.00 25.00 N Total Cylinders Shipped(Returned 15 15 ,y I ACCOUNTS PAST DUE WLL BE CHARGED PLEASE NOTE PAYMENT OF THIS INVOICE ACKNOWLEDGES THAT A SERVICE CHARGE OF$1 OR A FINANCE THE ABOVE SHIPMENTS,RETURNS,AND/OR BALANCE OF THE SUBTOTAL TAX AMOUNT ,INVOICE AMOUNT.z CHARGE OF 1.5%PER MONTH(18% PRAxAIN CYLINDERS IN YOUR POSSESSION IS CORRECT AT THE ANNUAL RATE)OF THE OUTSTANDING CLOSE OF BUSINESS ON THE DATE SHOWN ON THIS INVOICE. BALANCE,WHICHEVER IS GREATER OR 234.99 0.00 USD $ 234.99 CONTRACTUALLY ALLOWED. 343-011 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. $176.39 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 74603131 42-311.00 $176.39 1 hereby certify that the attached invoice(s),or 10/24/16 74603131 $176.39 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, October 24,2016 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 I QUESTIONS: COMMENTS: P4EgS RAPER 1N4UIf;IES REGARDING HS#INVOICEPlease note the format of your invoice has changedand nowincludes 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 600-2663369 Pay your bill by credit card! Call 1-800-266-4369 to start. INVOICE DETAIL AND PURCHASE DESCRIPTION- TERMS: Net 10 DaysPAYMENT DUE R0/16%201'f ITEM NUMBER ITEM DESCRIPTION QTY QTY BACK UOM VOLJWT UNIT AMOUNT SHIP RETN ORDER PRICE INVOICE NO:74603131 CUSTOMER:71675029 DATE:10/6/2016 SHIP FROM- 70613,PXPKG INDIANAPOLIS IN HS ORDER REFERENCE 84076275 DT 10/5/2016 PT# .CUSTOMER PO/RELEASE VERBAL TOM SHIP VIA Our Truck SHIP TO ACCOUNT:76168978 TOM 317-571-2630 OX.M-ADN OXYGEN USP AD(COC ONLY) 10 10 CO 9.62 96.20 N OX M-M i OXYGEN USP M 1 1 CO 29.74 29.74 N UMSCFCD2 ENERGY AND FUEL CHARGE USSURFEE 1 EA 12.50- 12.50 N U777HMD3- -HAZARDOUS MATERIAL CHARGE USSURFEE 1 EA 12.95 12.95 N UDELIVERYCHARGE DELIVERY CHARGE USSURFEE 1 EA 25.00 25.00 N Total Cylinders Shipped/Returned 11 11 ACCOUNTS PAST DUE WLL BE CHARGED PLEASE NOTE PAYMENT OF THIS INVOICE ACKNOWLEDGES THAT SUBTOTAL .LAX AMOUNT It YOiC I IOUNrI- A SERVICE CHARGE OF$1 OR A FINANCE THE ABOVE SHIPMENTS,RETURNS,AND/OR BALANCE OF THE CHARGE OF 1.5%PER MONTH(18% PRAXAR CYLINDERS IN YOUR POSSESSION IS CORRECT AT THE ANNUAL RATE)OF THE OUTSTANDING CLOSE OF BUSINESS ON THE DATE SHOWN ON THIS INVOICE. BALANCE,WHICHEVER IS GREATER OR 176.39 0.00 USD $ 176.39 CONTRACTUALLY ALLOWED. 343-01F