319444 12/12/17 i
y. ''• CITY OF CARMEL, INDIANA VENDOR: 360202
ONE CIVIC SQUARE 982,PRAXAIR DISTRIBUTION INC CHECK AMOUNT: $""""*'297.20'
?� CARMEL, INDIANA 46032 DEPT CH 10660 CHECK NUMBER: 319444
9MiruN � PALATINE IL 60055-0660 CHECK DATE: 12/12/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER.' AMOUNT DESCRIPTION
1120 4231100 70062016 297.20 BOTTLED GAS
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VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 360202 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
982-PRAXAIR DISTRIBUTION INC IN SUM OF$ CITY OF CARMEL
DEPT CH 10660 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.
PALATINE, IL 60055-0660
Payee
$297.20
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
70062016 42-311.00 $297.20 1 hereby certify that the attached invoice(s),or 12/6/17 70062016 $297.20
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
Friday, December 08,2017
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
QUESTIONS: COMMENTS:
Please note the format of our invoice has changed and now includes more
PLEASE REFER IN
REGARDING THISiNVO10E 70 Y 9
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 A1!MENT DUE12/312017�
ITEM NUMBER ITEM DESCRIPTION CITY QTY BACK UOM VOLAVY UNIT AMOUNT TA;
SHIP RETN ORDER PRICE YP
INVOICE NO:80062016 CUSTOMER:716750291 DATE:11/23/2017
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SHIP FROM 70613,PXPKG INDIANAPOLIS IN HS
ORDER REFERENCE 53154301 DT 11/22/2017 PT#
CUSTOMER PO/RELEASE VERBAL TOM
SHIP VIA Our Truck
SHIP TO ACCOUNT:76168978
****TOM PAYNE 317-741-0153****
OX M-AD OXYGEN USP AD 16 12 CO 9.62 153.92 N
OX M-M OXYGEN USP M 3 3 CO 29.74 89.22 N
UMSCFCD2 ENERGY AND FUEL CHARGE 1 EA 12.50 12.50 N
UZZZHMD3 HAZARDOUS MATERIAL CHARGE 1 EA 13.95 13.95 N
UDELIVERYCHARGE DELIVERY CHARGE 1 EA 27.61 27.61 N
Total Cylinders Shipped/Returned 19 15
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ACCOUNTS PAST DUE WLL BE CHARGED PLEASE NOTE PAYMENT OF THIS INVOICE ACKNOWLEDGES THATSUBTOTAL .LAX AMOUNT tNUOIC�AMOUNT a
A SERVICE CHARGE OF$1 OR A FINANCE THE ABOVE SHIPMENTS,RETURNS,AND/OR BALANCE OF THE �^�x ;.r
CHARGE OF 1.5%PER MONTH(18% PRAXAIR CYLINDERS IN YOUR POSSESSION IS CORRECT AT THE
ANNUAL RATE)OF THE OUTSTANDING CLOSE OF BUSINESS ON THE BATE SHOWN ON THIS INVOICE.
BALANCE,WHICHEVER IS GREATER OR 297.20 0.00 USD $ 297.20
CONTRACTUALLY ALLOWED.
343-01F