177262 09/15/2009 r
CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
0 ONE CIVIC SQUARE INDIANA OXYGEN CO CHECK AMOUNT: $183.24
CARMEL, INDIANA 46032 PO BOX 78588
a o INDIANAPOLIS IN 46278 CHECK NUMBER: 177262
CHECK DATE: 9115/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
2201 4231100 00569150 46.14 BOTTLED GAS
2201 4231100 00570105 X59.60 BOTTLED GAS
2201 4231100 08051863 x%0.06 BOTTLED GAS
601 5023990 08052348 7.44 OTHER EXPENSES
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V LIIMLJLfI IlL-IV 1 P1L- IIV V VIVL
I N IAIIV /k INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
Diffom 1 P.O. BOX 78588 INVOICE: 08051863
INDIANAPOLIS, IN 46278 -0588 INV DATE: 08/31/09
317 290 -0003 SALESPERSON: 0 0 0 TERR: 007
BRANCH: 004
P /O:
TERMS: NET 3 0
B S
I CARMEL STREET DEPT H CARMEL STREET DEPT
L 3400 W 131ST ST 1 3400 W 131ST ST
L P
WESTFIELD IN 46074 WESTFIELD IN 46074
T T
O O
INVOICE AMOUNT: 70.06
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
INV BEGINNING ENDING LEASED CYLINDER EXTENDED
P ITEM INVOICE DATE INVOICE B ALANCE SHIPPED RETURNED BALANCE CYLINDERS BAVDAYS RATE AMOUNT
R 050 1 0 0 1 0 31 .310 9.61
R 11X 1 0 0 1 1 0 .310 .00
R 147 3 0 0 3 0 93 .340 31.62
R 220 2 1 1 2 0 62 .310 19.22
R 330 1 0 0 1 0 31 .310 9.61
TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL 70.06
3400 W 131ST ST INVOICE: 08051863
WESTFIELD IN 46074 INVOICE DATE: 08 /31/09
TOTAL CYL VALUE: 1600. 0 0 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ORIGINAL INVOICE
i NDIANYk INDIANA OXYGEN COMPANY C 078 PAGE: 1
P PDX 78588 INVOICE: 005691. ORDER: 012 0571 7 -0 0
INDIANAPOLIS, IN 46278.0588 INVDATE: 08_/2 ORDDATE: 08/2
317 290 -0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 TINT: TIM j
P /O: CV
TERMS: NET 30
SHIP VIA: Will Call
RELEASE
B S
I CARMEL STREET DEPT H CARMEL STREET DEPT
L 3400 W 131ST ST F 3400 W 131ST ST
WESTFIELD IN 46074 WESTFIELD IN 46074
T T
O O
INVOICE AMOUNT: 46. 14
I
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
-ITEM Ory orY DESCRIPTION I _IJOM_ UNIT AMOUNT
Location:
OX 220 1 0 1 1 OXYGEN, COMPRESSED, 2.2 CYL 40.182 40.18
UN1072
220CF 18.2645/100CF
FSCFUEL SRCHGWC 1 0 TEMP DIESEL SURCHARGE W/C EA I 3.01 3.01
�HMCHAZ MAT CHG 1 O HAZARDOUS MATERIAL, CHARGE EACH 2.95 2.95
Subtotal 46.14
TOTAL CYLINDERS SHIPPED: 1 RETURNED: 1
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Due to current fuel prices IOC
has! adjusted the Fuel Sur barge
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Taxable amount: 0.00 1
CARMEL STREET DEPT CUSTOMER: 07851 46.14
3400 W 131ST ST INVOICE: 00569150q•'
WESTFIELD IN 46074 INVOICE DATE: 08/25/09
ORDER: 01205717 -00 P /O: CV
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ORIGINAL INVOICE
1I �T�1 INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAG 1
P.O. BOX 78588 INVO 005701_0 O RDER 0120 -01
INDIANAPOLIS, IN 46278 -088 INVDATE: 08/28/09 ORDDATE: 08/25/09
317 290 -0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 TINT: TIM
P /O: Z
TERMS: NET 30
SHIP VIA: UPS
RELEASE
B S
I CARMEL STREET DEPT H CARMEL STREET DEPT
L 3400 W 131ST ST F 3400 W 131ST ST
WESTFIELD IN 46074 WESTFIELD IN 46074
T T
O O
INVOICE AMOUNT: 59 60
PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
__.____ITEM —I QTY QTY DESCRIPTION'_ UOM UNIT AMOUNT
SHIP'D _ao PRICE
Location: D
THD9 -7726 10 0 TIP EA 5.96 59.60
Subtotal 59.60
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Due to current fuel pr ces IOC
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has adjusted the Fuel Sur harge
Taxable amount:j 0.00 j
CARMEL STREET DEPT CUSTOMER: 07851 y•.." 59.60
3400 W 131ST ST INVOICE: 00570105
WESTFIELD IN 46074 INVOICEDATE: 08/28/09
ORDER: 01205834 -01 P /O: Z
INDIANA OXYGEN COMPANY P.O. BOX 78588 o INDIANAPOLIS, IN 46278 -0588
n
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))
08/25/09 00569150 $46.14
08/28/09 00570105 $59.60
08/31 /09 08051863 $70.06
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$175.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 00569150 42- 311.00 $46.14 1 hereby certify that the attached invoice(s), or
2201 00570105 42- 311.00 $59.60
bill(s) is (are) true and correct and that the
2201 08051863 1 42- 311.00 $70.06
materials or services itemized thereon for
which charge is made were ordered and
received except
//thursday/sep 7 "ber 10, 2009
Street Commissioper
Street uoT, ssioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
INV ITEM INVOICE DATE: INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED BAUDAYS CYLINDER EXTENDED
p RAI ANCF. BALANCE CYLINDERS RATE AMOUNT
R 020 1- 0 0 1- 0 0 .310 .00
R 144 1 0 0 1 1 0 .310 .00
R 147 1 0 0 1 1 0 .340 .00
R 210 0 2 1 1 0 24 .310 7.44
R 337 1 0 0 1 1 0 .310 .00
TAX: .00
CARMEL WATER TREATMENT PLANT CUSTOMER: 12598 TOTAL 7.44
3450 W 131ST ST INVOICE: 08052348
WESTFIELD IN 46074 -8267 INVOICEDATE: 08/31/09
TOTAL CYL VALUE: 800.00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78,588 INDIANAPOLIS, IN 46278 -0588
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
154252
INDIANA OXYGEN CO Purchase Order No.
PO BOX 78588 Terms
INDIANAPOLIS, IN 46278 Due Date 9/8/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/8/2009 08052348 $7.44
I hereby certify that the attached invoice(s), or bill(s) is (are) true and �1
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date O er
VOUCHER 092914— WARRANT ALLOWED
1`54252 IN SUM OF
INDIANA OXYGEN CO
PO BOX 78588 ,Q Z
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
08052348 01- 6200 -04 $7.44
Voucher Total $7.44
Cost distribution ledger classification if
claim paid under vehicle highway fund