HomeMy WebLinkAbout167098 12/17/2008 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CHECK AMOUNT: $45.35
1 CARMEL, INDIANA 46032 PO BOX 78588
INDIANAPOLIS IN 46278 CHECK NUMBER: 167098
CHECK DATE: 12/17/2008
DEPARTMENT ACC OUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 00509774 45.35 BOTTLED GAS
ORIGINAL INVOICE
INDIANA INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
P.O. BOX 78588 INVOICE: 00509774 !ORDER: 01102853 -00 j
INDIANAPOLIS, IN 46278 -0588 INV DATE: 12/04/08 ORD DATE: 12/03/08
317 290 -0003 SALESPERSON; 00 TERR: 007
BRANCH: 004 TINT: JS
P /O: SHOP
TERMS: NET 30
SHIP VIA: Will Call
RELEASE
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: 45.35
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
I
I ITEM SHH�FD moo' DESCRIPTION UOM PRICE
AMOUNT
Location: D
�OX 220 1 0 1 2 OXYGEN, COMPRESSED, 2.2 CYL 38.452 38.45
UN1072
1 I 220CF 17.4782/100CF
�FSCFUEL SRCHGWC! 1 01 TEMP FUEL SURCHARGE W/C EA 3.95 3.95
IHMCHAZ MAT CHG 11 01 HAZARDOUS MATERIAL CHARGE EACH 2.95 2.95
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Subtotal 45.35
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TOTAL CYLINDERS SHIPPED: 1 RETURNED: 2i
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indianaoxygln.co
email in4oice@indianaoxylen.com
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Taxable amount: 0.00
CARMEL STREET DEPT CUSTOMER: 07851 AMOUNT 45.35
3400 W 131ST ST INVOICE: 00509774
WESTFIELD IN 46074 INVOICEDATE: 12/04/08
ORDER: 01102853-00 P /O: SHOP
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$45.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
P Board Member
2201 00509774 42- 311.00 $45.35 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
Friday, December 12, 2008
Street Co issioner
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))
12/04/08 00509774 $45.35
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