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162574 08/14/2008 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1 ONE CIVIC SQUARE INDIANA OXYGEN CO i 0 CHECK AMOUNT: $8.50 CARMEL, INDIANA 46032 PO BOX 78588 INDIANAPOLIS IN 46278 CHECK NUMBER: 162574 CHECK DATE: 8/14/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4231100 475989 8.50 BOTTLED GAS ITEM,: DESCRIPTION UOM UNIT AMOUNT SHIF ID ado -`PRICE' Location: b WLTlON45 5 0 #10 ALUMINA NOZZLE 5/8" EA 1.70 8.50 Subtotal 8.50 I n.co email invoice @indianaoxy en.com ITaxabl amount: 10.00 CARMEL STREET DEPT CUSTOMER.: 078 51 8.50 e 3400 W 131ST ST INVOICE: 00475989 WESTFIELD IN 46074 INVOICEDATE: 07/18/08 ORDER: 01038629 -01 P /O: H INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588 ITEM sQ Evo DESCRIPTION UOM UNIT AMOUNT Location: WLTlON25 3 0 1/8 3,2 COLLET EA 1.17 3.51 Subtotal 3.51 i i india aoxyggn.co emaiil inv @indianaoxy en.com Taxable amount: 0.00 CARMEL STREET DEPT CUSTOMER: 07851 3.51 3400 W 131ST ST INVOICE: 00477390 WESTFIELD IN 46074 INVOICEDATE: 07/24/08 ORDER: 01038629 -02 P /O: H INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588 VOUCHER NO. WARRANT NO. Indiana Oxygen ALLOWED 20 IN SUM OF P. O. Box 78588 Indianapolis, IN 46278 -0588 $12.01 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 2201 00475989 42- 311.00 $8.50 1 hereby certify that the attached invoice(s), or 2201 00477390 42- 311.00 $3.51 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 Thursday, July 31, 2008 Street mmissioner 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)) 07/18/08 00475989 $8.50 07/25/08 00477390 $3.51 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