319222 11/30/17 ,. CITY OF CARMEL, INDIANA VENDOR: 154252
_ ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $********24.98*
a CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 319222
9M, o INDIANAPOLIS IN 46278 CHECK DATE: 11/30/17
„4 roN c
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 01686144 24.98 REPAIR PARTS
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
Vendor# 154252
INDIANA OXYGEN CO IN SUM OF$ CITY OF CARMEL
PO BOX 78588 An invoice or 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.
INDIANAPOLIS, IN 46278
Payee
$24.98
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
01686144 42-370.00 .$24.98 1 hereby certify that the attached invoice(s),or 11/28/17 01686144 $24.98
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
Tuesday, November 28,2017
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
Qry ;QTv
ITEM „ srtia D. DESCRIPTION UOM AMOUNT
elo'.�. - _. E .
PRI
** Location: D **
VIC1424-0002 1 0 2"X50 CFH AR/35 CFH CO2, GOLD EA 24.983 24.98
GAUGE
Subtotal 24.98
Visit us at fac book or on the
web at ww .indi naox gen. om
Taxable amount: 0.00
CARMEL CITY OF FIRE DEPT. CUSTOMER: 94698 24.98
FIRE STATION #1 INVOICE: 01686144 ,
2 CIVIC SQUARE INVOICE DATE: 11/21/17
CARMEL IN 46032 ORDER: 02566420-00 P/O: CTC SHOP
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS, IN 46278-0588