HomeMy WebLinkAbout184802 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 9
ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $112.46
CARMEL, INDIANA 46032 PO BOX 78588
4 rop INDIANAPOLIS IN 46278 CHECK NUMBER: 184802
CHECK DATE: 4/2712010
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 00622867 112.46 BOTTLED GAS
r
ORIGINAL INVOICE
JNQIANIA INDIANA OXYGEN COMPANY CUSTOMER: 07 PAGE: i c
P.Q. BOX 78588 INVOICE: 00622867 I ORDER: 01298807-00
INDIANAPOLIS, IN 46278 -0588 INV DATE: 04/16/10 ORD DATE: 04/16/10
317 290 -0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: DD I
PIO: 4/16/2010
TERMS: NET 30
SHIP VIA: Will Call
RELEASE N:
B S
I CARMEL STREET DEPT H CARMEL STREET DEPT
3400 W 131ST ST P 3400 W 131ST ST
WESTFIELD IN 46074 WESTFIELD IN 46074
T T
O O
INVOICE AMOUNT: 112.46
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
__ITEM SHIP D QTY DESCRIPTION UOM I R "CE AMOUNT
Location: D
OX 220 1 0 1 1 OXYGEN, COMPRESSED, 2.2 CYL 23.79 23.79
UN1072
i
220CF 10.8136/100CF
AL S 1 0 1 1 ACETYLENE, DISSOLVED, 2.1 CYL 55.99 55.99
UN1001
i 147CF 38.0884/100CF
RECORD "ACTUAL" CUBIC FOOTAGE
F
CF
CF
r c.60 -175CF /CYL)
HAR535618x36 I 5I O 5356 1/8 x 36 X 10# SOX ALUMINUM LS I 5.22 26.10
53561/8x36
FSCFUEL SRCHGWCI 1 0! TEMP DIESEL SURCHARGE W/C EA 3.63 3.63
HMCHAZ MAT CHG 1 OI HAZARDOUS MATERIAL CHARGE EACH 2.95 2.95
Subtotal 112.46
I
T OTAL CYLINDERS SHIPPED: 2 RETURNED: 2
i
I-
I
Due to current fuel price3 IOC
has adjusted the Fue Sur barge
I I
I
I
Taxable amount
CARMEL STREET DEPT CUSTOMER: 07851 112.46
3400 W 131ST ST INVOICE: 00622867
WESTFIELD IN 46074 INVOICE DATE: 04/16/10
ORDER: 01298807 -00 P /O: 4/16/2010
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
VOUCHER NO. WARRANT N
ALLOWED 20
Indiana Oxygen
IN SUM OF
P' O. Box 78588
Indianapolis, IN 46278 -0588
$112.46
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Member;
2201 00622867 42- 311.00 $112.46 1 hereby certify that the attached invoice(s), or
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
Thu sday;/�pril 22, 2010
f rl A
Stree n r
trPn ornnr loner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/16/10 00622867 $112.46
1 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
Clerk- Treasurer