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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