The URL can be used to link to this page

Home My WebLink About331781 10/30/18 y or tAAM �/ CITY OF CARMEL, INDIANA VENDOR: 154252 .I ® °• ONE CIVIC SQUARE INDIANA OXYGEN CO CHECKAMOUNT: $********46.28* s CARMEL, INDIANA 46032 PO BOX 78588 CHECK NUMBER: 331781 c\ %g: .y��roN�°. INDIANAPOLIS IN 46278 CHECK DATE: 10/30/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 9135208 46.28 OTHER EXPENSES VOUCHER NO. 183154 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995) ALLOWED 20 Vendor # 154252 IN SUM OF$ 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 46.28 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 or bill(s)is(are)true and correct and that PO# ACCT# 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 9135208 01-6200-06 $46.28 and received except 10/24/2018 9135208 $46.28 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 ITEM QTY QTY CYLINDER' DESCRIPTION UOM UNIT AMOUNT SHP'D BO •SHP'D RET'D PRICE CD50RB 1 0 1 0 CARBON DIOXIDE(LIQUID WITHDRAW) CYL $35.785 $35.79 HMCHAZ MAT CHG 1 0 Hazardous Material Charge $6.95 $6.95 FSCFUEL SRCHGWC 1 0 Diesel Fuel Surcharge Walk-In $3.54 $3.54 Cylinder Shipped Total: 1 Cylinder Returned Total: 0 Subtotal $46.28 Tax(0%) $0.00 Delivery $0.00 Total $46.28 CARMEL WATER CUSTOMER 12598 • 3450 W 131 ST ST $46.28 • CARMEL IN 46074-8267 INVOICE: 9135208 INVOICE DATE: 10/20/2018 ORDER: 292840203 P/O: NONE INDIANA OXYGEN CO. • P.O.BOX 78588 • INDIANAPOLIS, IN • 46278-0588 Visit us on facebook at facebook.com/indianaoxygencomgank or at www.indianaoxygen.com ¢ Yy Indiana Oxygen Co. ORDER Corporate Office & Indianapolis Branch CUSTOMER# 12598 (317)290-0003 ORDER# 292840203 Bloomington Cincinnati Dayton Elkhart Fishers Fort Wayne (812)330-9210 (513)353-2448 (937)818-4264 (574)295-4433 (317)841-0002 (260)918-0241 DATE 10/18/2018 Lafayette Marion Muncie Seymour Vincennes (765)474-7095 (765)662-8700 (765)289-2373 (812)522-4421 (812)882-4323 PAGE 1 of 1 America's Oldest GasMelding Supply CUSTOMER I II IIIIIIIII I IIII s CARMEL WATER H 3450 W 131ST STREET ORDER P CARMEL, IN 46032 I IIIIII III IIIIIIIII VIII I T 317-733-2855 0 NAME - CARMEL WATER P.O.# NONE SALES INITIALS.; TK REL# BRANCH- Indianapolis TIME 10:13 AM PHONE#. 317-733-2855 INV LOC-'I Central Warehouse I Indy PRINT DATE 10/18/18 SHIPVIA Will Call PAYMENTI Charge Notes' ITEM DESCRIPTION ' QTY ,_ QTY CYLINDERS UNIT_-_' VOLUME/ '_ „ UNIT v'" EXTENDED 'NO AND,HAZARDCL'ASS ORDER BKORD SHIP- REIN- -WEIGHT AMOUNT AMOUNT- CD50RB CARBON DIOXIDE (LIQUID 1 0 1 1 CYL 437 ! $35.785 $35.79 WITHDRAW) 177 ITEM _ - DESCRIPTION_ --,—QTY .� `QTY._ -UNIT', _ _ �� BIN"`- <-.-UNIT '-_ EXTENDED . NO ORDER' BKORD LOC AMOUNT AMOUNT HMCHAZ MAT CHG Hazardous Material Charge 1 $6.95 $6.95 FSCFUEL SRCHGWC Diesel Fuel Surcharge Walk-In 1 $3.54 $3.54 Subtotal $46.28 Tax(0%) $0.00 Shipping $0.00 - Total $4.6,28 V� SPECIAL INSTRUCTIOINS: PLACARDS: 0 ACCEPTED it REFUSED EMERGENCY RESPONSE TELEPHONE NUMBER:8005355053 TERMS AND CONDITIONS Customer authorizes Seller to debit Customer's credit card or deduct from the THE CUSTOMER HEREIN CONSENTS TO AND ACCEPTS THE ABOVE PRODUCTS Customer's deposit an outstanding balance remaining On the Customer's account. SUBJECT TO ALL OF CONDITIONS AS SET FORTH ON REVERSE SIDE HEREOF P y g g AND THEjX TING CO TRACT BETWEEN BOTH PARTIES. TERMS AND CONDITIONS X v CG,1 G t I'1 " J� The Customer herein consents to and accepts the above products subject to all of Indiana Oxygen Co.Inc.'s terms and R CEIVED Y IGNATURE) DATE conditions,found on the company's website at indianaoxygen.com/corporate-terms-and-conditions.Should Customer desire a copy of terms and conditions in paper form,contact your representative or call 317-290-0003.Further,when X applicable,Customer's signature verifies shipped and returned rental cylinder count. SHIPPED BY - ORIGINAL