319502 12/12/17 o
CITY OF CARMEL, INDIANA VENDOR: 154252,:ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $**'****194.51
CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 319502
INDIANAPOLIS IN 46278 CHECK DATE: 12/12/17
DEPARTMENT ACCOUNT PID NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 01686172 42.75 OTHER EXPENSES
1120 4237000 01691220 151.76 REPAIR PARTS
VOUCHER NO. 173501 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor # 154252 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
INDIANA OXYGEN CO CITY OF CARMEL
PO BOX 78588 An invoice or bill to be properly itemized must show: kind of service,where performed,
INDIANAPOLIS, IN 46278 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
42.75 154252 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR INDIANA OXYGEN CO Terms
Carmel Water Utility PO BOX 78588 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), INDIANAPOLIS,IN 46278
PO# ACCT# or bill(s)is(are)true and correct and that
the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
01686172 01-6200-06 $42,75 and received except 11/30/2017 01686172
$42.75
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_
Clerk-Treasurer
�Qw- Qrr.__ OE UNIT — —
ITEM.` SCRIPTIO,N ,-UOMAINOUN f
.,.. -BHIP'D_ .;,B/O ., .. _ .. .. , .. ,PRICE:,::".,
** Location: **
CD SORB 1 0 1 1 CARBON DIOXIDE, 2.2 CYL 33.759 33.76
UN1013 (LIQUID WITHDRAW)
50CF @ 67.5180/1000F
FSCFUEL SRCHGWC 1 0 DIESEL SURCHARGE W/C EA 3.04 3.04
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EA 5.95 5.95
Subtotal 42.75
=AL =INDERS SHIPPED: 1 RETURNED: 1
Visit us cn fac book or oi the
web at ww .indi naox gen. om
Taxable amount: 0.00
CARMEL WATER CUSTOMER: 12598 • • 42.75
3450 W 131ST ST INVOICE: 01686172 ,
CARMEL IN 46074-8267 INVOICEDATE: 11/21/17
ORDER: 02566549-00 P/O:
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS,IN 46278-0588
INDIANA INDIANA OXYGEN (COMPANY, INC.
P.O. BOX 78588 - DELIVERY TICKEI
■ INDIANAPOLIS, INDIANA 46278-0588 i .
Bloomington + Cincinnati Elkhart + Fishers + Fort Wayne + Indianapolis
(812)330-9210 (513)353-2448 (574)295-4433 (317)841-0002 (260)918-0241 (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 4061842845
CUSTOMER 12596
ORDER'
02566549
—i_0
CARMEL.. wATER
34,50 (,I 131ST STREET ORDER DATE 11/21/17
CARMEL IN 460 32 PAGE 001 OF o0I
NAME CARMEL 1-AI TER, TERR 007 SHIP VIA Will Call -NONE- INITIALS TIM
P.O.# SALES 000 SHIPCODE 00 UPS 0 ORDER TYPE CHRG
REL# BRANCH 001 COLIPPD PREPAID TIME 21-NOV-17 08:57AM
PHONE# 317-733-2855 t,,'EL ROUTE# USERNAME tisk
QTY LIMIT !til ---------DESCRIPTION----------- ID LINE ------ITEN------ LOC CITY -CYLINDERS- VOLUbiE1 UNIT EXTENDED
SHIP & HAZARD CLff% NumfiER E'G'O ASR ORDER SHIP RETIN WEISHT AjV1NT AMOJJNT
1 CYL` CARBON DIOXIDE, 2.2 J. CD SORB A I 1 1 50 33.759 33.76
Lei1013 (LIQUID WITHDRAW)
177.00
@TY UNIT Hid ---------DESCRIPTION------------ LINE ------ITEM------- LOC OTY QTY BIN FEIGHT UNIT EXTENDED
SHIP & HAZARD CLASS till NUMBER ORDER BKORD LOC AMOUNT €�,'�IUNT
I EA DIESEL. SURCHARGE W C 2 FSC FU:L 5RCHGWC A 1 0 .00 3.04 3,04
I EP HAZARDOUS MATERIAL CHARGE 3 TX HAZ MAT CHG A 1 0 .00 5.95 5.95
- Total Weight: 177.0+.100 —. Subtotal 42.75
Tax
Freight .00
Total Sale 42.75
•1 /fin
SPE �LY P�lllvp iELEPHONE NUIVER- 8005355053 PLACARDS: ACCEPTED REFUSED
Custmer authorizes Seller to debit Customer's Credit Card or deduct fro® the TERMS,&CONDITIONS
HE CUSTOMER HEREIN CONSENTS TO AND ACCEPTS THE ABOVE PRODUCTS
Custoiaer's deposit any outstanding balance remaining, on the Custoleer's aC000 JECTTOALLOFTHECONDITIONSASSETFORTHONREVERSESIDEHEREOF
AND THE EXISTING CONTRACT BETWEEN BOTH PARTIES.
IMPORTANT / ,
PLEASE READ CAREFULLY THE TERMS AND CONDITIONS OF SALE WHICH APPEAR RECEIVED 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
CI)STnMFR
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 154252 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
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
$151.76
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
01691220 42-370.00 $151.76 1 hereby certify that the attached invoice(s),or 12/8/17 01691220 $151.76
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
ITEM -arr aTv: -
DESCRIPTION UOM AMOUNT
PRICE
** Location: D **
VIC0387-0072 1 0 6-MFA-1-CS #6 HEATING NOZZLE, EA 111.00 111.00
ONE PIECE ROSEBUD FOR 100 SERIES
NOR66254499894 2 0 4-1/2 X 5/8-11 NORTON BLAZE TYP EA 12.98 25.96
LAZE TYPE 27 HIGH DENSITY
NOR66254461155 2 0 41/2X5/8-11 60GRIT FLAPDISC EA 7.40 14.80
R884P BLUEFIRE W/FIBERGLASS BACK
Subto al 151.76
Visit us at fac book or oi the
we at ww .indi naox gen. om
Taxable amount: 0.00
CARMEL CITY OF FIRE DEPT. CUSTOMER: 94698 • 151.76
•
FIRE STATION #1 INVOICE: 01691220
2 CIVIC SQUARE INVOICEDATE: 12/04/17
CARMEL IN 46032 ORDER: 02571258-00 P/O: CTC / TRAINING
INDIANA OXYGEN COMPANY • P.O. BOX 78588• INDIANAPOLIS,IN • 46278-0588