HomeMy WebLinkAbout197069 05/11/2011 a CITY OF CARMEL, INDIANA VENDOR: 355856 Page 1 of 1
ONE CIVIC SQUARE AIRGAS MID AMERICA CHECK AMOUNT: $44.62
CARMEL, INDIANA 46032 PO BOX 802615
CHICAGO IL 60680 CHECK NUMBER: 197069
CHECK DATE: 5/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 111270677 44.62 MATERIALS SUPPLIES
ORIGINAL INVOICE
S 116111 1 0=14 11111191=11111116 e
Airgas Mid America INVOICE DATE GUST. NO. INVOICE NO. DUE DATE PAY THIS AMOUNT
Air �s. PO Box 1117 04/21/11 A3X18 111270677 05120111 $44.62
Bowling Green, KY 42102 -1117
AMOUNT ENCLOSED
SOLD sY AIRGAS -MID AMERICA
Check
5825 ELMWOOD AVENUE
INDIANAPOLIS IN 46203 -6032 Credit Card
317- 783 -2331 Please visit www.airgas.com /onlinebillpay or
complete the information on the reverse side of this form.
T78 P182 *AUTO MIXED AADC 296 PLTO 019347
SOLDTO (CITY OF CARMEL SEWER III III' II "IIII'l "'lli'
1 CIVIC SQ Airgas Mid America
{4" CARMEL IN 46032 -2584
PO Box 802615
Chicago, IL 60680 -2615
CAW 00A3X180011127067700000044625
TO ENSURE PROPER CREDIT PLEASE RETURN THE UPPER PORTION WITH YOUR REMITTANCE. FOR QUESTIONS ON YOUR ACCOUNT PLEASE CALL 304 325 -5702 x 6521
ORDER INVOI E'NUMBER' ACCOUNTiNLIMBER 'i €NVDICEDATE` 3 k'.:". ACGOUNT -NAME
104997 -00 111270677 A3X18 04/21/11 CITY OF CARMEL SEWER
•CUSTOMER QRDER'sNtlME3E€?
::SRN. F':SLS,€ TERR
"Sfl€P VIA ..rTERMS �c'PAGE
CARMEL WELDING AGENT 019 14 14 PICK -UP NET 30 DAYS 1
nELIVER RD
Y', OER
�xx
r QrY oTY cYLIr�DER d U UNIT
PART_NUMBER IP
SNPED aro DESCRIPTIDN r 30 PRICE AMOUNT
aHao' tz�rD ,M n_
RELEASE LARRY EIDSON
LOCATION: O1
10499 03 :30SRCACETYLENECL 1 0 ACETYLENE SURCHARGE EA 1.6500 1.65 N
LOCATION: YC
10499"03-30 C MC 1 a ACETYLENE SIZE MC (CL UO CL 38.9700 38.97 N
CGA 200
1 1 VOL: 1.0
1.0499`C3;30HAZHAZMAT 1. C HAZARDOUS MATERIALS CHAR EA 4.00 4.00 N
Subtotal 44.62
TOTAL CYLINDERS SHIPPED: 1 RETURNED: 1
TAX C :0;00000001 TAX DES RP:I DIA A SALE TAX CT:0031201550 -010 E P:01/O1/37
rAXASLEAMOuNT AMOUNTS`- t'.
$.00 1 THIS'INVOICEI'j 44.62
ffirga SHIP TO:
www.airgas.com CITY OF CARMEL SEWER ACT. NAME AIRGAS MID AMERICA
Airgas Mid America 130 1 STAVE SW ACT. NO. 8606074123
PO sox 1117 CARMEL IN 46032 -2009 PNC BANK- ABA NO. 031000053
Bowling Green, KY 42102 -1117 REF. 111270677/A3X18
sE .oamoo ORIGINAL INVOICE
VISA MASTERCARD DISCOVER AMEX Exp. mm/yy
Card
CVV (3-digit number in signature panel on back of card)
Print Name
Card Billing Address_
Card Holder's Phone Number
Signature
If you are-faxing this form please provide your Airgas acct and Invoice
from the reverse side.
Disclosure
Teo�s of SI[e: Each solo or Goods msemicexbyuvAimm"company is and shall be governed hy the tom*and conditions onohk� Disclosure, the Terms m Sale affixed w
umAc--cru one has bee mu Terms of Sale found at ltLr)..i!www.a ,,erviwALqT)s,asj)x (collectively the "Ternns of SaleA
Each commutm,mnoaem Good, u,smvicv between Seller and Buyer (zon^ac0
shall include these Terms orSsle.mummo with any other material oosu/mnume
Goods u, services being said, their price, delivery terms, and all other special provisions, ^oonuv'emrym any items of,ane/u/a personal property xmmueum any Contract
v,owonvis,vm,muuuvaa/e'toBuyer.
This document shows the. total number ^/(-xnnuors cxm,oeu/oouv^,(u, cylinders which oexerxmu,emewo/
eased m Buys; and which Buyer has not nyon`ed) aocmdinum Seller's records mom the month ending date shown- The number mowmuom thus charged maox, shall v°
considered correct to' all contractual purposes between Buyer and Seller, unless Buyer reports to Seller /c writing any errors Buyer *a/mo within oouaysamarm* date hereof,
Bu�r agrees to Continue 00 pay rent or- Lill cylinders chtwacd to Buyer until Bu has either (I) rQkffued such (,vIind0r-- In Seller w ,00d working order or (i;! pavo S-Mor lhe
revm'emomuommo"mf.
Retri_quant Cylir Refillable refrigerant cylinders shall remain the property of Alrqas or its third-party vericom, Such cylirders shall not be used riv Customer
for purposes othu than the storage of gas prodzcts puiuhasud from Airgas or Pic return and reclarnation of certain gasos k o g refrigerants). Ea;h rufitkiLlk cyArder will be
,subjez.t to e c daipo�Jt fee, as estabikhed by Airgas frorn time to Iijinp. Airc as will refund the deposit fee when the Custorner returns the refr:� 'S the
.1 gernril: cylinder Uriie,
oylindoi'q cor is deerned 10 be U11fit for reuse, as d1plen-nined by Airgas, whidi determination shall be irrefutable qixty days after the cyfi-ricir reLirfied,
All products, om^,iane uruu/a, qx/,uers and other containers fum/nx,m by on Airgas company a»ao mnfonn to the uoucwn:on ,xorcofpvolis:od by the
nnoufacmmrm the xmvm sale and will mee Seller's purity specifications for all gas products. SELLER SPECIFICALLY DISCLAIMS ANY OTHER EXPRESS oRIMPLIED
nn^woARoo, nu^mAmreEo. OR WARRANTIES, INCLUDING ANY WARRANTIES OF msmoxAwrxa/urr, nrmsao FOR p^ar/oumm punrous on wow'
/wpmwacmswrmvoAwYvwRnAwr/EST**rw^voE,4LsosoTo^pmE^»»nsaVcrnFouaToMoeuSmas.
SELLER SHALL BE LIABLE ONLY FOR THE REPAIR OR REPLACEMENT OF DEFECTIVE GAS CYLINDERS AND PRODUCTS, INCLUDING
THE REPLACEMENT OF GASES THAT DO NOT MEET ITS PURITY SPECIFICATIONS WITH GASES THAT DO MEET SUCH SPECIFICATIONS. BUYER KNOWINGLY
AND FULLY ASSUMES THE RISKS OF TRANSPORTING AND USING COMPRESSED GASES. SELLER SHALL NOT BE LIABLE FOR ANY DIRECT As
EXPRESSLY PROVIDED HEREIN). INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL AND/OR PUNITIVE DAMAGES, ARISING OR Al.LEGED TO ARISE 0, t-"T OF
OR IN CONNECTION WITH ITS PERFORMANCE OF ANY OBLIGATIONS ORANY PRODUCT, OTHER ITEMS OF SALE, oe EQUIPMENT SOLD om LEASED a,
SELLER, WHETHER SUCH DAMAGE RESULTS FROM ANY NEGLIGENT ACT OR OMISSION OR IS RELATED TO STRICT LIABILITY, OR OTHERWISE.
Terms oL2auy—rc Unless olherwiso specified in a Contract, Buyer shall make pa in full within 30 days af!er the date of Seller's invoice. ate pa char o,1o%
oo the mpuu, past due m,/axc*wI000mnuessem"nmnm/ two dollars ($znD).n/ the ^mx/mvm lawful rat=aouwau1e the state where the Goods are delivered,
wmvinvve,u�`�
lrile to �u�omud.r/uomon,enm|w"/n-n^"t shall remain m Seller's name. Buyer shall not cover, mouny. remove o,nu`i.-�nw/se disturb any identification other muio/aur
Seller's owm,m*/non any renmlequipment.
Taxes- ^'`ytamm/mvoi°uvmuo'm.muLe.o,mh°r mmexm/avavmvunmoso/e, uspnrpnnsessmnofoocuo. u
rompm*v—s:anua paid u/ouye,o` addition m the purchase price,
8 u :/xv�'u/am"vnr=e/mm/m,ouve,nmvmv/uuevoxuu*no/n/zoxrxumvs.muvumu�c,wm x the materials m
o/oan�,,mnnaw
n
Witt) laws and regulations *,""em/"uxuca,'C!nvs.nu,e^a/sI charges for handlin deliver and smnp/no�oncxo,-oa,m"fo'anor< 9yv, fuel, None o/ the char represent atax
or fpe paid mm Imposed ur any government authorit and all of the noa mmem.oeouvumueoa^rxaue/m,oasnvt specifically w,omm'm the "xa/oom/nh^wo°nthe
char and the actual costs associated With the charges, which can var oy product, service, time and place, among other things,
.oexamAiuS companies are u�. government contractors arid subcontractors arid are subject to and adhere m;bvrcv"/.cmu.tuor federal laws,
exe,.mvy orders, arid attendant m/°sand reo"w."n,. specifically Executive Order No. 1, 1246. the nm//*wo^uo"xc[ of/onand the v/mnamsnivo,erav,oe*4v`o"oot
Assistance Act n/1or4. all "samended.
Airgas eo"amoss
mc�oomo»vmnes^wimmma,u^au/o,mun*"erwxoo"'^u"^.^esv=obsue.:up://www.aimmu.,mm, v*//"son/me,ouyvm see how mmw.a/rgas.unmcan save y ou
time and moorv.
VOUCHER 115003 WARRANT ALLOWED
355856 IN SUM OF
AIRGAS MID AMERICA
PO BOX 802615
CHICAGO, IL 60680
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
111270677 01- 7200 -02 $44.62
Voucher Total $44.62
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
355856
AIRGAS MID AMERICA Purchase Order No.
PO BOX 802615 Terms
CHICAGO, IL 60680 Due Date 4/28/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/28/2011 111270677 $44.62
I hereby certify that the attached invoice(s), or bills) is (are) true and
correct and I have audited same in accordance with IC 5-11-10-1.6
Date Officer