156213 02/06/2008 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $83.68
INDIANAPOLIS IN 46278
CHECK NUMBER: 156213
CHECK DATE: 2/6/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4232100 00428503 83.68 GARAGE MOTOR SUPPIE
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ITEM QTY I QTY DESCRIPTION I UOM UNIT AMOUNT
j BHiP C b u PRICE
Lo.cat_ion:
FML5356035X1 2 0 ER5356 .035 X 1# SPOOL LB 8.34 16.68
MIP206188 25 0 TIP,FASTIP .312 OD .045 AND .040 EA 1.13 28.25
AL WIRES i
ITIL582 -10 1 0 12.5' 1.75" CABLE COVER -CD EA 38.75 38.75
Subtotal 83.68
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www.indianaoxygen.com f
email invoice @indianaoxygen.com
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Ta xable amount: 0.00
CARMEL STREET DEPT CUSTOMER: 07851 83.68
3400 W 131ST ST INVOICE: 00428503
WESTFIELD IN 46074 INVOICEDATE: 01/23/08
ORDER: 00962080 -00 P /O: MIKE773 -2001
INDIANA OXYGEN COMPANY P.O. BOX 78588 e INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
r 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.
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Payee
�✓JI� 1 Cx.�.(. 0 1 cx Q 4 Purchase Order No.
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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
C). �I 5
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ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
()Cd LE50J j 83. l0 b 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
FE 0 4 200 0
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64Y, EL
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund