173930 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 360618 Page 1 of 1
ONE CIVIC SQUARE STEPHANIE MARSHALL
o CARMEL, INDIANA 46032 578 TULIP POPPLUR CREST CHECK AMOUNT: $373.76
CARMEL IN 46033 CHECK NUMBER: 173930
CHECK DATE: 6/2412009
DEPART ACCOUNT PO NUMBE INV OICE NUMBER AMOUNT DESCRIPTION
902 �e_� 4359003 373.76 FESTIVAL /COMMUNITY EV
5/28/2009 10:22 AM FROM: IOC FAX TO: +1 (317) 571 -2789 PAGE: 001 OF 001
I N M ANA OXYGEN COMPANY, INC.
P.O. ]BOX 78588 DELIVERY men
INDIA "OLIS, INDIANA 46278.0588
low Bloomington Cincinnati Fishers 1 Indianapolis
(812) 330 -9210 (513) 353 -2448 (317) 841 -0002 (317) 290.0003
Lafayette Marlon Muncie Seymour Vincennes
V65)474-7095 (765) 662- 8700 (765) 289 -2373 (812) 522 -4421 (612) 882-0323
[meriea's Oldest Gas/Welding Supply 1931319865
CU ST OMER 21366
ORDER 0 1 1 50051 -00
CARMEL ART DESIGN DISTRICT
Ill W MAIN ST ORDER DATE 04/06/19
CARMEL IN 46035 PAGE 002 OF 002
OOIZ -5 r1 -2797
WE CARK'L ART DESIGN DISTRICT TERR If81 SHIP VIA Our Truck NX- INOMS NG
O SALES $HIP CODE go UPS ORDER TYPE CASHED
9RMIQH�1 CavPFD PREPAI TIME 87- APR-09 87:56AN
IONEI gA&ML ROUTE# USERNAME natag
OTV UNIT HN --DE RIPTIDN LINE I TEM•--- LOC ATV QTY BIN II£ISHT UNIT EXTENDED
SHIP >r HAZARD CLASS No NUMBER ORDER BKORD LOC ANQUNT A[40IINT
I
e COD ORDER Hee
Freight 13.25
Total Sale 268,11
I
r
ECIAL INSTRUCTIONS: PLACARDS: 0 ACCEPTED REFUSED
ERV RESPt3lISE I13 Ep}(M (R; TERMS a CONDITIONS
THE SUBJECT CUSTOMER LL OF THE ON AS SET FORTH RT N REVERS SID OF
AND THE EXISTING CONTRACT BETWEEN SCTT}I PARTIES.
IMPORTANT X
ASE READ CAREFULLY THE PERMS AND CONDITIONS OF SALE WHICH APPEAR RECEIVED BY ISIGNATIAi6J DATE
THE REVERSE SIDE OF THIS DOCUMENT. ALL SALES MADE ARE SUBJECT TO
:H TERMS AND CONDITIONS. CUSTOMER SIGNATURE HEREON VERIFIES x
PPED AND RETURNED RENTAL CYLINDER COUNT.
SHIPPED eV
ORIGINAL
STATE OF INDIANA
SS:
COUNTY OF HAMILTON
AFFIDAVIT
I, Stephanie Marshall, state that 1. expended the following on behalf of the Carmel Redevelopment
Commission for the purchase of a helium tank from Indiana Oxygen for special events and activities.
April 9, 2009 260.11 (helium tank)
TOTAL L260.1 1
Dated this 22 "d Day of May 2009.
5teph ie Marshall
Subscribed and sworn to before me, the undersigned Notary Public, this 22" day of May, 2009.
3
Sherry ielke AOTARY AJBLIC
Resident of Hamilton County, Indiana
My Commission Expires:
November 5, 2016
S7n' f
My
[eb: msword :z :MsmielkelfortnsiafTadivitma� hall 05 22 09.do :5122/09]
Barof America I Online Banking I Accounts I Account Details I Account Activity Page 2 of 4
.009 0411712009 $965.4
0412012SIMPLY SWEET SHOPPEQ46 �k
04/17/2009 04/15/2009 MEIJER INC 11130 $21. 36 Q01 803.64
.04/1.6/200.9 .0.. KROGER #959 4/15/2009 4..54 .$782.28 7�
04/15/2009 04/13/2009 PARTY TREE INC $30.31 $719.51
https:// ccss- rva. bankofamerica. com /ccss /g _printab]eversion.el_uif 4/23/2009
Bank of Affierica I Online Banking I Accounts I Account Details I Account Activity Page 3 of 4
"1',"", 11 1 1.." -.1-1.11,
04/13/2009 04/1212-009 KROGER #959 2.) $631.58
-.1 1
04/13/2009 04/12/2009 KROGER #959 C7 $604.94
-.1 1 I I
04/10/2009 04/09/2009 IN OXYGEN INDY 260. 11 $587.46 1
STORE
-11-
04/08/2009 04/06/2009 PARTY TREE INC 9.63) $967.43
I
-
https:l/ccss-rva.bankofamerica.com/cess/g_printableversion.el 4/23/2009
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 {Rev. 1995)
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.
m Payee 1
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoices) or bill(s))
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4 f IS U kT
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6
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1Z 0
4j G w CI
09
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Total
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
i
VOUCHER NO._ WARRANT NO.
ALLOWED 20
S6hr,01't m.CA S )'1a-1 1 IN SUM OF
3s73, %7r
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
U Z J, 3 bill(s) is (are) true and correct and that the
D X 135�LLz 3 9 materials or services itemized thereon for
Qo Z oa'5 13 which charge is made were ordered and
w Z �35`too 3 6 P 3 1 received except
Z 3 a .90
o;z °7. 14
Z �,,vu
'FU Z- 2 5 q[Sb3 o
ZZ 20 0
Signature
Director of Operations
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund