155353 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 7858e CHECK AMOUNT: $4,015.05
INDIANAPOLIS IN 46278 CHECK NUMBER: 155353
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 R4467099 17534 00420604 2,980.05 WELDER SPIRAL GUN
2201 R4467099 17534 00422340 915.00 WELDER SPIRAL GUN
2201 4467099 00422341 15.05 OTHER EQUIPMENT
2201 R4467099 17534 00422341 104.95 WELDER SPIRAL GUN
ORIGINAL INVOICE
IN :DIANA INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
P.O. BOX 78588 INVOICE: 00422341 ORDER: 00951888 -02
INDIANAPOLIS, IN 46278 -0588 INV DATE: 12/28/07 ORD DATE: 12/18/07
317- 290 -0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: TIM
P /O: JEFF
TERMS: NET 30
SHIP VIA: Will Call
RELEASE
B CARMEL STREET DEPT H CARMEL STREET DEPT
3400 W 131ST ST P 3400 W 131ST ST
WESTFIELD IN 46074 WESTFIELD IN 46074
T T
0 0
INVOICE AMOUNT: 120.00
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
ITEM QTY QTY _DESCRIPTION UQM UNIT AMOUNT.
SHIP'D B/O I I I
I I PRICE T.
Location: D
MIL195333 1 0 PROTECTIVE COVER,ENGINE DRIVE 21 EA 120.00 120.00
.5W X 45L X 28H
Subtotal 120.00
www.indianaoxyge— com
email invoice @'ndianaoxy en.com
Taxable amount:1 0.00
CARMEL STREET DEPT CUSTOMER: 07851 INV 120.00
3400 W 131ST ST INVOICE: 00422341 THIS
WESTFIELD IN 46074 INVOICEDATE: 12/28/07 INCLUDING TAX
ORDER: 00951888 -02 P /O: JEFF
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
Location: D
MIL195156 1 0 SPOOLMATIC 15A EA 915.00 915.00
SN: LH440681V
Subtotal 915.00
i
I
www.indianaoxygen.com
email invoice@lndianaoxyjen.com
Taxable amount: 10.00
CARMEL STREET DEPT INVO
CUSTOMER: 07851 915.00
3400 W 131ST ST INVOICE: 00422340
WESTFIELD IN 46074 INVOICEDATE: 12/28/07
ORDER: 00951888 -01 P /O: JEFF
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
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
1 Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8 C, C
8) O� a 1 5 CI
C����� ��0, CD
Total 5
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
�JYI CU 1(, Ceti 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
1 1 5,3 Co Qj) L09 C, O 50. bill(s) is (are) true and correct and that the
j j 5 3d 0(0 8 0 �1 Q �i q 5. materials or services itemized thereon for
0q a6► l l�_'`IO.�q )0�-�, Q S which charge is made were ordered and
received except
DD a 11 i 00. q q 15,
IAN 20
0 1A 1
I
Si ture
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund