HomeMy WebLinkAbout174938 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
q ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588
CHECK AMOUNT: $105.13
INDIANAPOLIS IN 46278 CHECK NUMBER: 174938
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBE INV OICE NUMBER AM DESCRIPTION
2201 4231100 00557085 37.33 BOTTLED GAS
2201 4231100 08043462 67.80 BOTTLED GAS
CYLINDER RENTAL INVOICE
INDIA INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
P.O. BOX 78588 INVOICE: 08043462
INDIANAPOLIS, IN 46278 -0588 INV DATE: 06/30/09
317 290 -0003 SALESPERSON: 0 0 0 TERR: 007
BRANCH: 004
P /O:
TERMS: NET 3 0
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
O O
INVOICE AMOUNT: 67.80
PLEASE SEND TOP PORTION WITH YOUR PAYMENT---
ENV ITEM INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED BAUDAYS CYLINDER EXTENDED
i,P BALANCE BALA CYLINDERS RATE AMOU
R 050 1 0 0 1 0 30 .310 9.30
R 11X 1 0 0 1 1 0 .310 .00
R 147 3 0 0 3 0 90 .340 30.60
R 220 2 0 0 2 0 60 .310 18.60
R 330 1 0 0 1 0 30 .310 9.30
TAX: .00
CARMEL, STREET DEPT CUSTOMER: 01851 TOTAL 67.80
3400 W 131ST ST INVOICE: 08043462
WESTFIELD IN 46074 INVOICEDATE: 06/30/09
TOTAL CYL VALUE: 1600.00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ORIGINAL INVOICE
4
W -DIANA INDIANA OXYGEN COMPANY CUSTOMER: 07 PAG E: 1
P.O. BOX 78588 INVOICE: 005570 ORDER 01184776 -00
INDIANAPOLIS, IN 46278 -0588 IN VDATE: 0_7/0 O RODATE: 07/0_1_/_0_9__
317 290-0003 SALESP 000 TERR 00 7_
BRANCH: 004 i INT BMK
P /O: 7/01/09
TERMS: NET 30
S HIP VIA: Will Call
RELEASE
B S
I CARMEL STREET DEPT R CARMEL STREET DEPT
3400 W 131ST ST P 3400 W 131ST ST
WESTFIELD IN 46074 WESTFIELD IN 46074
T T
O O
INVOICE AMOUNT: 37 33
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
I ITEM SQ IPD- wo DESCRIPTION U0M- PRICE AMOUNT
Location:
ICD 50 1 01 11 1 CARBON DIOXIDE, 2.2 CYL 31.61 31.61
UN1013
50CF 63.2200/100CF
FSCFUEL SRCHGWC 1' 0 TEMP DIESEL SURCHARGE W/C EA 2.77 2.77
HMCHAZ MAT CHG 1 0 HAZARDOUS MATERIAL CHARGE EACH 2.95 2.95
Subtotal 37.33
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I
TOTAL CYLINDERS SHIPPED: 1 RETURNED: l'
I I i
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I
Dud to current fuel price3 IOC
has! adjusted the Fuel Sur harge
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T axable amo unt:! j0.00
CARMEL STREET DEPT CUSTOMER: 07851 37.33
3400 W 131ST ST INVOICE: 00557085 LE
WESTFIELD IN 46074 INVOICEDATE: 07/01/09
ORDER: 01184776 -00 P /O: 7/01/09
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/30/09 08043462 $67.80
07/01/09 00557085 $37.33
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. WARR NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
R. O. Box 78588
Indianapolis, IN 46278 -0588
$105.13
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 08043462 42- 311.00 $67.80 I hereby certify that the attached invoice(s), or
2201 00557085 42- 311.00 $37.33
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
F'rid y,.Ju 7, 2009
'Street' Comir'issOner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund