307987 02/13/17 CITY OF CARMEL, INDIANA VENDOR: 154252
CHECK AMOUNT: $********14.85'
ONE CIVIC SQUARE INDIANA OXYGEN CO
PO BOX 78588 CHECK NUMBER: 307987
1
�`. CARMEL, INDIANA 46032 INDIANAPOLIS IN 46278 CHECK DATE: 02/13/17
�«iroN.ia
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCEQUIPMENT RIPTIONREPAIRS & M
1094 4350000 8427721 14.85
Voucher No. Warrant No. Allowed 20
�� —
154252 Indiana Oxygen Company
P.O. Box 78588
Indianapolis, IN 46278-0588 In Sum of$
$ 14.85
ON ACCOUNT OF APPROPRIATION FOR
1o9 Monon Center
Board Members
PO#orAMOUNT
INVOICE NO. CCT#/TITL
Dept# 14.85 1 hereby certify that the attached invoice(s), or
1094 8427721 4350000 $ bill(s)is(are)true and correct and that the
materials or services itWefeedthe ordered and eon r
which charge is made
received except
Februa 10, 2017
1PACHVMlAtAl
signature
Accounts Pa fable Coordinator
$ 14.85 Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
INy ITEM INVOICE DATE INVOICE BEGINNING SHIPPED P.ETURNED ENDING LEASED BAUDAYS CYLINDER. - EXTENDED
P BALANCE BALANCE CYLINDERS RATE AMOUNT
SHP SMALL HIGH PRESSURE 1 0 0 1 0 31 .439 13.61
CMF ASSET MANAGEMENr FEE 1.24 1.24
TAX: .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL 14.85
1411 E. 116TH ST. INVOICE: 08427721
CARMEL IN 46032 INVOICEDATE: 01/31/17
TOTAL CYL VALUE: 100.00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN • 46278-0588