205498 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 154252 Page 1 of 1
ONE CIVIC SQUARE INDIANA OXYGEN CO
CARMEL, INDIANA 46032 PO BOX 78588 CHECK AMOUNT: $170.35
INDIANAPOLIS IN 46278
CHECK NUMBER: 205498
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER IN NUMBER AMOUNT DESCRIPTION
2201 4237000 00776016 85.03 REPAIR PARTS
2201 4231100 08169471 75.12 BOTTLED GAS
601 5023990 08169901 10.20 OTHER EXPENSES
CYLINDER RENTAL INVOICE
IN I-ANik INDIANA OXYGEN COMPANY CU 07851 PAGE: 1
DIME P.O. BOX 78588 INVOICE: 08169471
INDIANAPOLIS, IN 46278 -0588 INV DATE: 12/31/11
317 290 -0003 SALESPERSON: 0 0 0 TERR: 007
BR 00 4
P /O:
TERMS: NE'P 3 0
B CARMEL STREET DEPT H CARMEL STREET DEPT
3400 W 131ST ST P 3400 W 1.31ST ST
CARMEL IN 46074 CARMEL IN 46074
T T
0 0
INVOICE AMOUNT: 75.12
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
INV ITEM: INVOICE'DATE INVOICE BEGINNING.. SHIPPED'. RETURNED ENDING LEASED ggLIDAYS CYLINDER EXTENDED,['.
BALANCE BALANCE CYLINDERS RATE AMOUNT
ALY ACETYLEN 3 0 0 3 0 93 .369 34.32
ARG ARGON 2 0 0 2 1 31 .329 10.20
CO2 CARBON DIOXIDE 1 0 0 1. 0 31 .329 10.20
OXY OXYGEN 2 0 0 2 0 62 .329 20.40
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TAX: .00
CARMEL STREET DEPT CUSTOMER: 07851 ®.1. 1 75.12
T07AL
3400 W 131ST ST INVOICE: 08169471
CARMEL IN 46074 INVOICE DATE: 12/31/11
TOTAL CYL VALUE: 2400.00 P /O:
INDIANA OXYGEN COMPANY a P.O. BOX 78588 INDIANAPOLIS, IN 46278 -0588
ORIGINAL INVOICE
INDIAN INDIANA OXYGEN COMPANY CUSTOMER: 07851 PAGE: 1
P.O. BOX 78588 INVOICE: 00776016 ORDER: 015 61041 -00 j
INDIANAPOLIS, IN 46278 -0588 INV DATE: 01/06/12 ORD DATE: 01/05/12
317 290 -0003 SALESPERSON: 000 TERR: 007
BRANCH: 004 INT: TRM
P /O: SHOP VERBAL MIKE
T ERMS: NET 30
SHIP VIA: UPS
REL EASE j
B CARMEL STREET DEPT H CARMEL STREET DEPT
3400 W 131ST ST P 3400 W 131ST ST
CARMEL IN 46074 ATTN; MIKE
T T CARMEL IN 46074
O O
IN VOICE AMOUNT: 85.03
PLEASE SEND TOP PORTION WITH YOUR PAYMENT
QTY QTY UNIT
'T�� sHIP'o B/o DESCRIPTION! UOM- PRICE
AMOUNT
Location: W
WLTTC -3 -10Z 2 0 COVER BLACK NYLON, 3" X 11' EA 37.80 75.60
ZIPPER CABLECOVER
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Subtotal 75.60
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Visit us at fac book or o the Freight 9.43
web at wwv .indi naox gen. ::om
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Ta xable amount: 0.00
CARMEL STREET DEPT CUSTOMER: 07851 85.03
3400 W 131ST ST INVOICE: 0077601.6
CARMEL IN 46074 INVOICEDATE: 01/06/12
ORDER: 01561041-00 P /O: SHOP VERBAL MIKE
INDIANA OXYGEN COMPANY P.O. BOX 78588 INDIANAPOLIS, IN e 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))
12/31/11 08169471 $75.12
01/06/12 00776016 $85.03
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. WARRA NO.
ALLOWED 20
Indiana Oxygen
IN SUM OF
P. O. Box 78588
Indianapolis, IN 46278 -0588
$160.15
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. A, fACCT#/TITLE AMOUNT Board Member,
2201 0816947 42- 311.00 $75.12 1 hereby certify that the attached invoice(s), or
2201 00776016 42- 370.00 $85.03 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
Wednesday, January 11, 2012
Street Commissioner
r v
Strte Cyr "Titlessicner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
7<<TJVi
NV ITEM INVOICE DATE INVOICE BEGINNING SHIPPED RETURNED ENDING LEASED gAL/DAYS CYLINDER EXTENDED
P ..BALANCE BALANC CYLINDERS RATE AMOUNT
R ALY ACETYLENE 1 0 0 1 1 0 .369 .00
R MIX MIX GASES 1 0 0 1 1 0 .329 .00
R NIT NITROGEN 1 0 0 1. 0 31 .329 10.20
R OXY OXYGEN 1 0 0 1. 1 0 .329 .00
R SHP SMALL HIGH PRESSURE 1- 0 0 1- 0 0 .329 .00
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TAX: .00
CARMEL WATER CUSTOMER: 12598 TOTAL 10.20
3450 W 131ST ST INVOICE: OP169901
CARMEL IN 46074 8267 INVOICE DATE: 12/31/1.1
TOTAL CYL VALUE: 1200.00 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 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 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201 08169901 $10.20
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
Date Officer
VOUCHER 113414 WARRANT ALLOWED
154252 IN SUM OF
INDIANA OXYGEN CO WATM
PO BOX 78588 OPERATIONS
INDIANAPOLIS, IN 46278
Carmel Water Utility
ON ACCOUNT PROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
08169901 01- 6360 -03 $10.20
Voucher Total $10.20
Cost distribution ledger classification if
claim paid under vehicle highway fund