HomeMy WebLinkAbout198148 06/06/2011 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CHECK AMOUNT: $26.11
CARMEL, INDIANA 46032 PO BOX 78588
4 moo INDIANAPOLIS IN 46278 CHECK NUMBER: 198148
CHECK DATE: 6/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 00719625 26.11 BOTTLED GAS
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUS 07851 PAG E: 1
P.O. BOX 78588 INVOICE: 007 19625 ORDER: 01464314 -00
INDIANAPOLIS, IN 46278 -0588 INVD 05/24/11 ORDDATE: 05/24/11
317-290-0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: DAB
P /O: I
TERMS: NL 30
SHIP VIA Will. Call
i
RELEASE I!:
B S
i CARMEL STREET DEPT CARMEL STREET DEPT
L 3400 W 131ST ST P 3400 W 131ST ST
CARMEL IN 46074 CARMEL IN 46074
T T
O O
INVOICE AMOUNT: 26. 11
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
='TV _,pr. Ter r n UNIT �nl
'iTEivr-. sHIP.D ero
D U n PRICE AMOUNT
Location:
CD 50 1 0 1 1 CARBON DIOXIDE, 2.2 CYL 18.90 18.90
UN1013
50CF 37.8000/1.00CF
FSCFUEL SRCHGWC 1 0 TEMP DIESEL, SURCHARGE W/C EA 4.26 4.26
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EACH 2.95 2.95
Subtoilal. 26.11
I `DOTAL CYLINDERS SHIPPED: 1 RETURNED: 1
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i Duej to cu rent fuel price IOC
hasadjus ed the Fue Sur barge
;Ta xable amount: j 0 0 0 Tom• I I
C:ARYIEL STREET DEPT CUSTOMER: 07851 26.11
3400 W 131ST ST INVOICE: 00719625
CARMEL IN 46074 INVOICEDATE: 05/24/11
ORDER: 01464314 -00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN m 46278 -0588
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))
05/24/11 00719625 $26.11
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
i
VOUCHER NO. WARRANT N
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$26.11
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Member;
2201 00719625 42 311.00 $26.11 I 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
Wednesday J"Ob'e 01, 2011
Street Commissi nrr�
ttl cc L' CO
Title <sslan
Cost distribution ledger classification if
claim paid motor vehicle highway fund