185896 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 363381 Page 1 of 1
ONE CIVIC SQUARE ON SITE GAS SYSTEMS, INC CHECK AMOUNT: $488.00
CARMEL, INDIANA 46032 35 BUDNEY ROAD
..off Lo. NEWINGTON CT 06111 CHECK NUMBER: 185896
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4353099 13793 488.00 OTHER RENTAL LEASES
02N� SITE Can Site Gas Systems, Inc.
Manufactures Designers of Oxygen Nitrogen Generating Equipment
35 Budney Road, Budney Industrial Park, Newington, CT 06111 USA
Telephone: 860.667.8888 Fax: 860.667.2222 www.onsitegas.com
Invoice Number: 13793
I Invoice Date: 5/11/2010
Page: 1 of 1
B CITY OF CARMEL S CARMEL FIRE DEFT
I ONE CIVIC SQUARE H 2 CIVIC SQUARE
L CARMEL IN 46032 -2584 1 CARMEL IN 46023
L USA P USA
T T
O O
7
Order Purchase Order Packa es Prepaid Wei ht Shi" Via Terms
L000000O14 12667 WA DUE UPON RECIEPT
Qty. Back
Line /Ref: Qty,Ordered Shipped Order .Date:Shipped Unit Price Extended Price
l 1.00 EA 1.00 0.00 8/7/09 488.00 488.00
Customer Item: Lease May 7, 2010 thru June 7, 2010
Item: L- 02FS -7
Serial 5362
,Sales Amount 488.00
Misc Charges 0.00
Freight 0.00
Tdtall 488.00
VOUCH ER NO. WARRANT NO.
ALLOWED 20
On Site -Gas Systems, Inc.
IN SUM OF
35 Budney Road
Newington, CT 06111
$488.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 13793 43- 530.99 $488.00 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
MAY 2 4 2010
Fire Chief
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))
13793 $488.00
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
Clerk- Treasurer