172374 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO, CHECK AMOUNT: $125.80
CARMEL, INDIANA 46032 PO BOX 78588
INDIANAPOLIS IN 46278 CHECK NUMBER: 172374
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
2201 4231100 00542220 58.00 BOTTLED GAS
2201 4231100 08035025 67.80 BOTTLED GAS
r�
CYLINDER RENTAL INVOICE
INI -MANA INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAG 1
P.O. BOX 78588 INVOICE: 08035025_
INDIANAPOLIS, IN 46278 -0588 INV DATE: 04/30/09
317 290 -0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 1
P /o: 1
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: 67.80
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
INV ITEM INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED CYLINDER EXTENDED
gAUDAYS
P BALANCE. .BALAN CYLINDERS -RATE AMOUNT
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 1.8.60
R 330 1 0 0 1 0 30 .31.0 9.30 I
i
I
I
I
I
I
L- I TA 00 I
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL 67.80
3400 W 131ST ST INVOICE: 0803502.5
WESTFIELD IN 46074 INVOICEDATE: 04/30/09
TOTAL CYL VALUE: 1600.00 P /O:
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
r
ORIGINAL INVOICE
INDI N INDIANA OXYGEN COMPANY CUSTOMER: 0 PAGE: 1
P.O. BOX 78588 INV OICE: 0 0
INDIANAPOLIS, IN 46278 -0588 INV DATE: 04/29/09 ORD DA TE: _0 4/29/09
317 290 -0003 SALESPERSON: 000 I TERR: 007
BRANCH: 004 INT: BM_K
P /O: SH OP
TERMS: NET 3
SHIP V IA: Wi. Ca
L RELEASE N:
B S
I CARMEL STREET DEPT H CARMEL STREET DEPT
3400 W 1 -31ST ST P 3400 W 31 S'L' ST'
WESTFIELD IN 46074 WESTFIELD iN 46074
T T
O O
INVOICE AMOUNT: 58.00
PLEASE SEND TOP PORTION WITH YOUR PAYMENT--------------------------------------------
ITEM sO ao DESCRIPTION UOM PRI CE 7 AMOUNT
j Location: D j
IFML535618X36 10 0 ER5356 1/8 X 36" LB 5.80 58.00
i
Subtotal 58.00
I
I j
I i
I i I
I
I
i
Due to current fuel price3 IOC
i
i has adjusted the Fuel Sur barge
i
I 1
Taxable amount:) 10.00
CARMEL STREET DEPT CUSTOMER: 07851 58.00
3400 W 131ST ST INVOICE: 00542220 I
WESTFIELD IN 46074 INVOICEDATE: 04/29/09
ORDER: 01160151 -00 P /O: SHOP
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
r
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))
04/29/09 00542220 $5?- .00
04/30/09 08035025 $67.80
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 N WARRAN NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$125.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PC B# /Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 00542220 42- 311.00 $58.00 I hereby certify that the attached invoice(s), or
2201 08035025 42- 311.00 $67.80 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
T urs May 07, 2009
I L
Street Commi s' er
Strut
Cost distribution ledger classification if
claim paid motor vehicle highway fund