157526 03/19/2008 1
CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $66.89
INDIANAPOLIS IN 46278 CHECK NUMBER: 157526
CHECK DATE: 3/19/2008
DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION
2201 4232100 00438749 23.10 GARAGE MOTOR SUPPIE
2201 4353099 00875444 43.79 OTHER RENTAL LEASES
NV ITEM INVOICE DATE INVOICE ggUDAY
BEGINNING SHIPPED RETURNED ENDING LEASED S CYLINDER EXTENDED
YP BALANCE BALANCE CYLINDERS RATE AMOU
R 050 1 0 0 1 0 29 .290 8.41
R 11X_ 1 0 0 1 1 0 .290 .00
R 147 2 0 0 2 0 58 .320 18.56
R 220 2 0 0 2 0 58 .290 16.82
TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL 43.79
3400 W 131ST ST INVOICE: 00875444
WESTFIELD IN 46074 INVOICEDATE: 02/29/08
TOTAL CYL VALUE: 1200.00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ITEM\ QTY QTY DESCRIPTION UOM UNIT AMOUNT
SHIP'n EVQ PRICE
Location: D
jMIP212240 1 0 MAGNIFYING LENS,DIOPTER 2.00 EA 7.49 7.49
UASJAC07'46 -00341 1 0 WC -5 GOGGLE SHADE 5 EA 15.61 15.61
TWEWS2162 I 0 2 NOZZLE 5/8 15,9MM EA 12.75 0.00
Subtotal 23.10 j
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www.indianaoxygen.co
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email invoice@indianaoxyjen.com
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j Taxable amount:) 0.00
CARMEL STREET DEPT CUSTOMER: 07851 AMOUNT 23.10 THIS INVOICE
3400 W 131ST ST INVOICE: 00438749 INCLUDING
WESTFIELD IN 46074 INVOICEDATE: 02/29/08
ORDER: 00982483 -00 P /O: H
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (Rev. 1995)
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.
I, Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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.
ALLOWED 20
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
W bj 5q4 5tC.0 4 �3;�1 bill(s) is (are) true and correct and that the
c�6, I C materials or services itemized thereon for
which charge is made were ordered and
received except
MAR 7 zoos 2
C eignatu auk L4
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund