160923 06/25/2008 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
t' ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $276.54
INDIANAPOLIS IN 46278
CHECK NUMBER: 160923
CHECK DATE: 6/2512008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 00465387 50.15 REPAIR PARTS
601 5023990 00465741 226.39 OTHER EXPENSES
f.
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ITEM QTY I.O DESCRIPTION UOM UNIT AMOUNT
SH!P'D E'O PRICE
Location: r D
REPGAS 1 0 REPAIR -GAS APPARATUS REP 50.15 50.15
REPAIR VICTOR CUTTING ATT. CA1350 T G #38321
Subtotal 50.15
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www
email invoice@i.dia
Tax amount:l 10.00
CARMEL STREET DEPT CUSTOMER: 07851 50.15
3400 W 131ST ST INVOICE: 00465387
WESTFIELD IN 46074 INVOICEDATE: 06/06/08
ORDER: 01019382 -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
$50.15
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 00465387 42- 370.00 $50.15 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
Thursday, June 19, 2008
Streg ommissioner
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))
06/06/08 00465387 $50.15
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
ITEM CITY Q DESCRIPTION UOM UNIT AMOUNT
cHiP'D �C PRICE
r Location: D
NI 80 j 1 0 1 1 NITROGEN, COMPRESSED, 2.2 CYL 17.752 17.75
UN1066 (72CF /CYL)
72CF 24.6556/100CF
CYL80 1 0 80 CF CYL SOLD OUTRIGHT EA 170.25 170.25
AL MC 1 0 1 1 ACETYLENE 10CF CYL 17.342 17.34
CGA -200
10CF 173.4200/100CF
IOX 20 1 0 1 1 OXYGEN, COMPRESSED, 2.2 CYL 14.145 14.15
UN1072
20CF 70.7250/100CF
I FSCFUEL SRCHGWC 1 0 TEMP FUEL SURCHARGE W/C EA 3.95 3.95
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE j EACH 2.95 2.95 j
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Subtotal 226.39
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'E'OTAL CYLINDERS SHIPPED: 3 RETURNED: 31
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www.indianaox
ygen.com
emalil inioice@indianaoxylen.com
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!Taxable amount: 0.00
CARMEL WATER TREATMENT PLANT CUSTOMER: 12598 226.39
3450 W 131ST ST INVOICE: 00465741
WESTFIELD IN 460.74 -8267 INVOICEDATE: 06/09/08
ORDER: 01028304 -00 P /O: 2264
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts
Form'No'301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
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
Mo. Day Yr. Signature Title
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. J
L o C ✓k cl�U
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER Dr--"�q ACCT.
r ,�3k5', INDIAN fn NO.
CL Favor Of Z
Total Amount of Voucher
Deductions
61 Lao
Amount of Warrant
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
1
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Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS SYSTEMS 1- 800 -382 -8702 325