HomeMy WebLinkAbout169954 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $63.28
INDIANAPOLIS IN 46278 CHECK NUMBER: 169954
CHECK DATE: 3/18/2009
DEPARTMENT A CCOUNT PO NUMBER INV OICE NUMBER AMOUNT DESCRIPTION
2201 4231100 08026674 63.28 BOTTLED GAS
r
CYLINDER RENTAL INVOICE
R
INDIANA INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
P.O. BOX 78588 INVOICE:' 08026674
INDIANAPOLIS, IN 46278 -0588 INV DATE: 02/28/09
317 290 -0003 SALESPERSON: 0 0 0 TERR: 007
BRANCH: 004
P /O:
TERMS: NET 3 0
B
I 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: 63 .28
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
INV BEGINNINFG SHIPPED RETURNED ENDING LEASED gAUDAYS CYLINDER EXTENDED
ITEM INVOICE DATE INVOICE
TYPE BALAN BALANCE .CYLINDERS RATE ..AMOUNT-
R 050 1 0 0 1 0 28 .310 8.68
R 11X 1 0 0 1 1 0 .310 .00
R 147 3 2 2 3 0 84 .340 28.56
R 220 2 2 2 2 0 56 .310 17.36
R 330 1 0 0 1 0 28 .310 8.68
TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851 TOTAL 63.28
3400 W 131ST ST INVOICE: 08026674
WESTFIELD IN 46074 INVOICEDATE: 02/28/09
1 TOTAL CYL VALUE: 1600.00 P /O:
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))
02/28/09 08026674 $63.28
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
VOUC NO. WARRANT NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$63.28
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 08026674 42- 311.00 $63.28 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
Friday, arc 2009
Street Commissioner
Strim. te0ornmissioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund