191245 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CHECK AMOUNT: $187.81
CARMEL, INDIANA 46032 Po eox 7858e
INDIANAPOLIS IN 46278 CHECK NUMBER: 191245
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 00664376 78.54 OTHER EXPENSES
601 5023990 07005762 99.70 OTHER EXPENSES
1094 4239012 8106196 9.57 SAFETY SUPPLIES
INV $17P- ANT;. PERIOD EXPIRATION. OYL
r GRGUV uATE :dESCRIPTION r RATE AMOUNT-__..:
L. hSED
L AC1 MIX 12 10/2010 07005762 1 99.70 99.70
W�
E OFFER 1 YEAR AND 5 YEAR LEASES
YR $183.04 PE CY L (ACETYLENE= $199.20) PLUS T
CARMEL WATER TREATMENT PLANT CUSTOMER: 12598 TOTAL 99.70
3450 W 131ST ST INVOICE: 07005762
CARMEL IN 46074 8267 INVOICEDATE: 10/05/10
P /O:
INDIANA -OX` Gl_RN_C:OMPANX -..P.O. BOX 78588.9 INDIANAPOLIS, IN 46278 -0588
orr ory F I ni_ I� UNIT
-1T�M, DESCRI. Y.O OAS- o.1�d0UNT-
Location: W
OX 80 1 0 1 1 OXYGEN, COMPRESSED, 2.2 CYL 19.51 19.51
UN1072
70CF 27.8714/100CF
AC 144 1 0 1 1 COMPRESSED GASES, N.O.S., 2.2 CYL 52.534 52.53
UN1956
144CF 36.4819/100CF
(75% ARGON 25% CARBON DIOXIDE)
FSCFUEL SRCHGWCI 1 0 I TEMP DIESEL SURCHARGE W/C j EA 3.55 3.55
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EACH 2.95 2.95
Subtotal 78.54
DOTAL CYLINDERS SHIPPED: 2 RETURNED: 2
I
I I
I
I
Due to current uel price IOC
has adjusted the Fuel i Sur harge
I
i
I
Taxable amount: 0.00
CARMEL WATER TREATMENT PLANT CUSTOMER: 12598 78.54
THIS INVoicr:
3450 W 131ST ST INVOICE: 00664376 1 1 INCLUDINGTAX
CARMEL IN 46074 -8267 INVOICEDATE: 10/06/10
ORDER: 01368008 -00 P /O: STEVE CALLAHAN
IiNDIANA COMPANY P.O. BOX 78588 .INDIANAPOLIS, IN. 9 46278 -0588
VOUCHER 103055 WARRANT ALLOWED
154252 IN SUM OF
IIV DIANA OXYGEN CO
PO BOX 78588
INDIANAPOLIS, IN 46278 0 c
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
00664376 01- 6200 -06 $78.54
b7 Ub 4Z Ol �3(czC• D3 �i°�
Voucher Total
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 10/18/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/18/201( 00664376 $78.54
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
Date Officer
h
CYLINDER RENTAL INVOICE
INQ.LANT, INDIANA OXYGEN COMPANY CUSTOMER: 03390 1 PAGE: 1
P.O. BOX 78588 INVOICE: 08106196
INDIANAPOLIS, IN 46278-0588 INV DATE: 09/30/10
317- 290 -0003 SALESPERSON: 0 0 0 1 TERR: 001
BRANCH: 001
4 7D E 61 S10/ NET 30
C
'r
B CARMEL CLAY PARKS H CARMEL CLAY PARKS
1235 CENTRAL PARK DR EAST P 1235 CENTRAL PARK DR EAST
CARMEL IN 46032 CARMEL TN 46032
T T
0 O
INVOICE AMOUNT: 9-57
PLEASE SEND TOP PORTION WITH YOUR PAYMENT----------------------------------------
INV ITEM t'VOICE DATE INVOICE' BEGwNING SHIPPED RETURNED EN DI_ BAUDAYS cvLINDER ExTENDED
NG RA6ANCE�. ANCF_ LEASED
..CYLINDERS TE 'AMO UNT
R SHP SMALL HIGH PRESSURE 1 0 0 1 0 30 .319 9.57
I
Due to increased regulatory costs on acetylene
IOC is increasing acetylene cylin er rental ra es TAX:' .00
CARMEL CLAY PARKS CUSTOMER: 03390 TOTAL 9.57
1235 CENTRAL PARK DR EAST INVOICE: 08106196
CARMEL IN 46032 INVOICE DATE: 09/30/10
TOTAL CYL VALUE: 75.00 wo:
INDIANA OXYGEN COMPANY a P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
154252 Indiana Oxygen Company Terms
P.O. Box 78588
Indianapolis, IN 46278 -0588
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
9130110 8106196 Oxygen cylinder 9.57
Total 9.57
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
Voucher No, Warrant No.
154252 Indiana Oxygen Company Allowed 20
P.O. Box 78588
Indianapolis, IN 46278 -0588
In Sum of
9.57
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 8106196 4239012 9.57 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
21 -Oct 2010
Signature
9.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund